Proof of Performance

Thank you for allowing us to take part in your mission. Every effort is made to support events and organizations that align with our charge to provide accessible and affordable health care in our community.

Please fill out the following form within 30 days after your event. If you have any questions, contact Diane Davis at didavis@hope-health.org.

Proof of Performance Form

Name of Organization & Submitter

Today's Date

Address

City

State/Province

Zip/Postal

Country

Phone

Brief Summary of Event

How did your organization use the funds given?

What were the demographics of the people served?

Please upload images of the event and HopeHealth logo placement.

Maximum file size: 134.22MB

How many people attended?

Date of Event

Captcha

If you are human, leave this field blank.

Making a Positive Difference in the Communities We Serve

Proof of Performance