St. Vincent Charity Health CampusProspective Tenant Questionnaire

St. Vincent Charity Health Campus

Prospective Tenant Questionnaire

Please complete this questionnaire to help us understand the nature of your request for space on-campus.

SECTION 1: TENANT INFORMATION

Operator/Organization name

Organization website

Organization tax status

Select or enter value

Type of business

Select or enter value

What is your organization’s mission?

What is your organization’s values?

Please describe your organization

Contact person:

Phone number

Phone

Email address

Headquarters Address

SECTION 2: FACILITY NEEDS

Estimated Square footage needed

Please describe the space needed:

Please address in particular:

Amount of space is public-facing (meeting with members of general public and how many)
Amount of space is administrative (#private offices, # work stations, # conference rooms and for how many)
Clinical space (# office, conference rooms, group rooms, waiting areas, staff lounges, etc.)

Hours of operation

Total number of employees

Estimated number of parking spaces (staff)

Do you have deliveries requiring load dock access?

Will you have needs for a food service department?

Will you have handicap access needs?

Do you need facility access on weekends/holidays?

Do you have a need for street-level access?

Do you need to be located near the front door?

What signage will you want to post and where?

List the locations your agency provides services

Purpose of space

How would your location on-campus complement your other locations?

Proportion of total space

In relation to the cumulative space(s) you rent and/or own, what percentage would your location on-campus be out of your total space usage (from a square-footage perspective)?

What is the timing of your space need?

Will you have specific security needs?

SECTION 3 - UTILITY NEEDS

Do you need cooking access?

Do you have specific restroom needs?

Do you need Information Technology assistance?

Do you need large amounts of electrical services?

Ex. computer main frames, refrigerators, etc.

Any events that occur outside regular work hours?

If so, please describe (ex. frequency)

Parking space needs

Explain the minimum number of parking spaces (staff and guest/client) you need (minimum and maximum) and time of day will they be needed:

Percentage of parking needed for handicap spaces

Estimated number of computer devices:

Estimated number of phones:

Desired bandwidth for Internet:

What supportive services will you need?

Ex. maintenance, janitorial

Do you have any specific building requirements?

Ex. HVAC, load bearing capacity

Any specific qualitative considerations?

Ex. need for privacy, need for street level visibility, or anything else you'd like to note about your space request?

Thank you for your time and interest!

Send me a copy of my responses

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