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INTEGRIS Health Community Giving Fund Grant Application

INTEGRIS Health has established priorities for improving community health for 2023 through 2025. These priorities are identified through a Community Health Needs Assessment (CHNA) conducted in the Oklahoma communities served by INTEGRIS Health. The INTEGRIS Community Giving Fund aligns giving with the INTEGRIS Health community health priorities.

Please complete the application below. A copy of the application will be emailed to the address provided.

In addition, include a copy of the following with this Application form:

  • One-page cover letter
  • Letter designating 501(c)3 status
  • Itemized program budget for the specific program for which you are requesting funds
  • Current list of board of directors

After submitting the form below please forward all attachments to tobi.campbell@integrisok.com by Oct 14, 2022.

Your application must be submitted before the deadline date of October 14, 2022. Applications that fail to meet the criteria or are otherwise incomplete will not be considered. All decisions concerning INTEGRIS Community Fund grants made by the Grant Committee will be final. Grants are restricted to nonprofit organizations within the INTEGRIS service area of Oklahoma.

By submitting the application, the organization is applying for consideration as a recipient of an INTEGRIS Health Community Fund Grant and has submitted the information required.

INTEGRIS Health Community Giving Fund Grant Application

INTEGRIS Health has established priorities for improving community health for 2023 through 2025. These priorities are identified through a Community Health Needs Assessment (CHNA) conducted in the Oklahoma communities served by INTEGRIS Health. The INTEGRIS Community Giving Fund aligns giving with the INTEGRIS Health community health priorities. INTEGRIS Health’s 2023-2025 community health priorities are Access to Care (including Mental Health, Obesity and Chronic Disease Prevention/Management), Access to Healthy Food, and Tobacco Use Prevention, through risk reduction and behavior change, screening, and treatment strategies. Evidence-based programs that promote health and wellness or create access to comprehensive medical care continue to be a priority of the Community Giving Fund. In order to qualify for grant funding, your program or service must align with one or more of following health priorities: (check appropriate boxes), and provide evidence-based data to support the program strategies (reported quarterly to INTEGRIS Health during your grant year): o Access to Care (includes Mental Health, Obesity and Chronic Disease Prevention/Management) – Improve access to medical care services, behavioral health, or substance use treatment. Improve the prevention, detection, treatment and/or management of depression, and reduce the suicide rates. o Access to Healthy Food– Improve access to healthy and affordable food and knowledge of healthy food and lifestyle choices. o Tobacco Use – Reduce vaping, electronic cigs, tobacco use and secondhand smoke exposure.

Assessment of the Need

Response to the Need

Describe program strategies that meet the need by providing the following:

(Note: All funds granted are to be spent and results reported during the grant year.)

Evaluation

(Quarterly data reports to grantor will be required during your grant year).

Sustainability

We can’t commit that we will always have funding, nor can we guarantee that your application will be successful in competing against others in upcoming funding cycles.

In addition to submitting this form, you will need to email a copy of the following to tobi.campbell@integrisok.com: • One-page cover letter • Letter designating 501(c)3 status • Itemized program budget for the specific program for which you are requesting funds • Current list of board of directors