FLORIDA GULF COAST UNIVERSITY
COLLEGE OF HEALTH PROFESSSIONS
DEPARTMENT OF NURSING
NUR 4636C COMMUNITY PARTNERED CARE
Community Resource Reports

Name of Agency:_________________________________________________________________

Address:________________________________________________________________________

Phone:___________________  Fax:_______________________E-mail:______________________

Contact Person:______________________________ Position/Title:_________________________

Target Population for Service:
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Services Avalilable:
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Eligibility Criteria for Service:
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Your Impression of this Agency and the Service(s) Offered:
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(Attach agency brochures)
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