Partnership Intake Form

Please complete the questionnaire to nofity the Office of External Affairs and Innovation of your intent to partner with Morehouse School of Medicine.

Contact Information

Phone

Business Information

Partnership Information

Do you have an existing or past partnership with Morehouse School of Medicine?

Select
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Please provide a brief synopsis of why you or your organization would like to partner with Morehouse School of Medicine.

Please include any additional information you believe is important to this partnership opportunity.

Please provide the deadline or target start date for this project opportunity, such as the RFP or grant deadline. If date is unknown or to be determined, please type TBD in the response field.

Please let us know if someone referred you to Morehouse School of Medicine. If not applicable, please type N/A in the response field.

If a meeting with a representative is already scheduled and/or has already occurred, please provide the meeting dates. Otherwise, type N/A in the response field.

To assist the Office of External Affairs and Innovation with scheduling a meeting regarding this potential partnership, please provide the name and contact email of the scheduler.

For questions and concerns regarding this form, please contact the Office of External Affairs and Innovation at oeai@msm.edu.