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Partnership Inquiry Form

Lifeline Health collaborates with public agencies, health systems, community organizations, and funders to design and scale community-based programs for HIV, Hepatitis C, and STI prevention and care.

This form helps us understand your organization’s goals and explore potential collaboration pathways. Submitting an inquiry does not constitute a commitment by either party.

Organization Information

Your Role in the Organization

Partnership Interest Area

Program Focus

Goals and Context

Partnership Stage

Alignment and Collaboration

Additional Information

Submitting this form initiates an exploratory conversation. Lifeline Health reviews partnership inquiries to assess alignment with mission, feasibility, and public health impact. We respect confidentiality and will not share submitted information outside of partnership evaluation without permission.