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VDFP Development Initiative Request Form

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VDFP Development Initiative Request

VDFP Development Initiative Request

This form is used to request support for collaborative initiatives that involve internal departments, external partnerships, or funding opportunities (e.g., grants, community collaborations). The goal is to ensure alignment with organizational priorities, appropriate administrative oversight, and consistent review processes.

Once completed, submit to the Program Director for endorsement. Once endorsed, the Director will submit the final version for Board consideration.

SECTION 1: BASIC INFORMATION

MM slash DD slash YYYY
Type of request:
MM slash DD slash YYYY
MM slash DD slash YYYY
MM slash DD slash YYYY

Section 2: Initiative Overview

Origin of request:

Nature of initiative:

Describe how this initiative aligns with the VDFP Strategic Plan or PCN Attributes.
Anticipated benefits (e.g., benefits to FPs, patients, or community).

SECTION 3: PARTNERSHIPS AND CONSULTATION

Collaboration type:
(Have we worked with this organization before?)
(E.g. co-funding with IH, Shared Care)
FP involvement (please select all that apply):
(E.g., elevate Division profile, develop partnerships, community connections)

SECTION 4: RESOURCES AND IMPLICATIONS

Required resources:
Staff time (estimate hours or FTE impact)
Contractor support
Materials or supplies
Other resources
 
(Impact on current operational funding)
Impact assessment: What potential risks or negative impacts could this have on current Division work?

SECTION 5: ADMINISTRATIVE DETAILS

Submission administration:

(Location for shared storage)
(How updates and correspondence will be managed)
Finance Committee review required?
Will there be event/engagement activities?
Event/engagement budget has been approved.

SECTION 6: INTERNAL REVIEW AND ENDORSEMENT

(Staff/contractor/member must present to Director prior to Board submission)
(Director/designate has approved consistency and completeness)

SECTION 7: FINAL DECISION

MM slash DD slash YYYY
Decision:
Get in Touch
  • Victoria Division of Family Practice
    404-1025 Johnson Street
    Victoria, BC V8V 0G7 Canada
  • [email protected]
  • 1-877-790-8492
  • 778-698-4570
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The Victoria Division of Family Practice acknowledges with great respect that our office is located on the traditional, ancestral, and unceded territories of the Lək̓ʷəŋən speaking peoples, known today as the Xʷsepsəm and Songhees Nations. We are grateful to be working on these lands. We are committed to ongoing learning and to actively contributing to reconciliation.

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The Victoria Division of Family Practice acknowledges with great respect and appreciation that our office is located on the traditional, ancestral, and unceded territories of the Coast Salish nations. We are privileged to be working on the lands of the Lək̓ʷəŋən (Lekwungen/Songhees) and WSÁNEĆ (Tsartlip, Tsawout, Tseycum) Peoples.

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