Funding Your Healthcare Vision Invite-Only Workshop

This is an intake for established organizations interested in getting a ticket to our workshop for women of color founders who want to secure consistent funding (grants & contracts) to support delivery of direct healthcare services to their communities.

Please note, we currently only support organizations that include service to low-income communities of color (including those on Medicaid), have been officially incorporated as a 501(c)3, PLLC, PC, LLC or S-corp for at least one year and provide direct health & wellness services to individuals.

After completion of the intake, if your organization is a good fit, we will send you the information to register for the workshop. Please note, there is an investment (low 3-figures) for this 3-hour workshop.

Please be as detailed as possible so we can have a very clear understanding of your organization.

First Name *

Last Name *

What is the preferred email address that you check on a regular basis? *

What is the legal name of your health organization? *

What is your cell phone number? *

Do you consent to receive text messages from Melanin & Medicine? *

Please list your most used social media profile URL here *

Business Website *

What is the name of the community (city and state) that your organization wants to serve in the next 12 months?

Describe the social mission of your organization: tell us about the type of patients you are supporting and what problem in the community is your practice addressing? *

Have you had any previous experience, either professionally or personally addressing this problem or providing these services in the past?

How long has your organization been operational and how many people total have you served? *

What was your previous year's gross revenue in your business (Jan - Dec of the previous year)?*

What is your current YTD revenue? *

What is your 2023 goal for revenue of the organization? *

What is your 2023 goal for reach of your organization? *

What is your 2023 goal for impact of the organization? *

What are the three biggest things you want Dr. Omolara and our coaching team's help with during the workshop? *

What are the top 1-3 challenges in your organization when it comes to getting funding to achieve your revenue, reach & impact goals? *

Describe what you want your organization to look like 12 months from now? *

Why is now the right time for you to register for this workshop? *

How many people are in your organization (include contractors, VAs, part-time and full-time team members) *

Do you have any other healthcare consultants that you are currently working with? *

If this was referred by someone, who is it that we need to thank?

Our Funding your Healthcare Vision Workshop will require you to be in attendance on March 25th (from 3-6pm) as we will NOT send out a replay. We will discuss how your organization can not only position itself for funding but how to overcome challenges that prevent them from securing grants and how to overcome them. Are you prepared to make a low 3-figure investment for mentorship to get your organization ready to add grants & contracts as an additional revenue stream for your organization? *

How ready are you to get support with creating funding partnerships that bring grants and contracts to your organization? *

What type of program format works best for you given your time, energy and learning style? *

In order to best serve you, please do not submit this form if you are not interested in investing the time and attention during the workshop to support funding and growth of health equity-centered organization.

We take these applications very seriously and we spend time and energy to ensure that you have the best information possible for execution.

Keep in mind that the more detailed your answers, the more likely we are able to have enough information to accept your application for the workshop.