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Community Benefit Activity Report
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Laren Bay Region
Community Benefit Activity Report
Community Benefit Activity Report menu
McLaren Health Care - Hospitals in Michigan
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The Doctor Is In
Record Your Activities to be counted in the Community Benefit Report
Note:
Fields marked with an
*
indicates required field
Internal Information
Title of Activity:
*
Cost Center Number:
*
Coordinating Department:
*
Contact Person:
*
Phone:
*
Community Needs
Brief Description of Activity:
*
Broad Goals of Activity:
*
Is this a collaborative effort outside of McLaren Bay Region?
*
Yes
No
If yes, Please list the organizations:
Is this activity duplicated in the community?
*
Yes
No
Does this activity address any identified, unmet community need?
*
Yes
No
Event Information
Date of Activity:
*
Persons Serviced:
*
Hours spent by paid staff:
*
Names and Titles of Staff Members:
*
Persons Served:
*
Hours spent as volunteers:
*
Expense Information
Either enter dollars specified, or paid:
*
Purchased Services:
*
Supplies:
*
Other Direct Expenses:
Indirect Expenses:
Funding & Offsetting Revenue
Support from Foundation/Fundraising:
Grants/Support:
Other:
Captcha*
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