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Partner Form

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Please indicate your interest in participating in We Can!® by completing and faxing this contract to the NHLBI Health Information Center at (240) 629-3246.

You may also download a PDF of the Partnership Commitment Formpdf document icon (350 KB).

Note: Documents in PDF format require the Adobe Acrobat Reader.external disclaimer If you experience problems with PDF documents, please download the latest version of the Readerexternal disclaimer

  Primary Contact Information






  Secondary Contact Information








  We Can! Partner
Yes! We are interested in serving as a We Can! partner and would like to discuss doing the following:

We Can! Partner Requirements

Organizations interested in serving as a We Can! partner will be asked to:

  • Utilize and disseminate We Can! program messages and materials to members and other audiences
  • Designate a representative who can participate in We Can! national and local promotional activities
  • Provide an online description of the We Can! program and its resources, and link to the We Can! website
  • Provide feedback on use and impact of We Can! outreach and program messages and materials
  • Promote participation in the We Can! movement to other groups in its industry/field, the media, etc.
  • Support We Can! in testing messages and products, and evaluating them

Partnership Period and Sustainability

  • We Can! partnerships will be evaluated annually based on participation and organizational contributions. Updates with organizations on lead contacts and levels of commitment will be renewed to ensure that the energy level and interest in the
    partnership will carry through the coming year.
  • Organizations will be asked at onset of participation to complete a Memorandum of Understanding (MOU) and Trademark Licensing Agreement (TML) with the National Heart, Lung, and Blood Institute. MOUs and TMLs are typically active for a minimum of one year.

Last Updated: February 13, 2013