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Criteria Faqs Deadlines & Grant Cycle Stanzler Advisory Group Apply

Stanzler Fund Apply Faqs Advisory Board

Marjorie Stanzler Fund Application

Application Deadline: August 30, 2024

If you are interested in the MSF and have an organization of fewer than 100 staff, please contact membership@theschwartzcenter.org prior to applying.

Thank you for applying for the Marjorie Stanzler Fund. All applicants will be notified of their status in October 2024.

Please note: The form does not allow for save and return functionality. We strongly recommend saving your responses in a Word or Google doc and copying and pasting in case the browser closes unexpectedly or you experience other technical issues.

Participation in or viewing a recording of our Schwartz Center informational webinar is required prior to submitting. If you have yet to do so, you can receive the dates of upcoming webinars along with other introductory information by completing a membership inquiry form here.

If you have questions, please contact membership@theschwartzcenter.org.

I have participated in or viewed a recording of the Schwartz Center informational webinar.

First Name

Last Name

Suffix (MD, RN, LCSW, etc.)

Job Title

Email Address

Phone Number

Please enter numbers only, with no dashes.

What is the full, unabbreviated name of your organization (ex. Alpha Rehabilitation Hospital)?

Organization Address:

Street 1

Street 2

City

State

Zip

Website

If your member organization is part of a larger healthcare system (ex. Alpha Health), please let us know which one:

Contact information for Project Leader (main point of contact with the Schwartz Center for the Marjorie Stanzler Fund application and materials):

Same as aboveDifferent from above

First Name

Last Name

Suffix

Job Title

Email Address

Phone Number

Please enter numbers only, with no dashes.

How did you hear about the Marjorie Stanzler Fund?

How do you classify your healthcare institution?

HospitalHome care agencyHospiceInsurance planLong-term care facilityMedical school/educational institutionMedical transport serviceOrgan and tissue donationOutpatient facilityPhysician groupResidential treatment centerGovernment agencyOther (please specify):

Academic medical centerAcute care hospitalCancer centerChildren’s hospitalCommunity/regional hospitalCritical access hospitalPsychiatric hospitalRehabilitation hospitalVeterans’ administrationOther (please specify):

Ambulatory surgery centerBehavioral healthCommunity health centerDiagnostic and laboratory testingPrimary careWomen’s health clinicOther (please specify):

Number of FTE

Number of beds (if not applicable, please note N/A in the field):

Distance from closest acute care facility:

0 – 25 miles26 – 50 miles51 – 99 miles100+ miles

Please describe your organization’s payer mix (i.e., Medicare, Medicaid or equivalent, Indigent, Self-Pay, Other Third Parties, Veterans Administration).

Please describe how your organization demonstrates a commitment to diversity, equity, inclusion and belonging.

Please provide your organization’s financial summary and a description of financial need.

Optional: Please upload any additional materials related to your organization's financial summary.

Please upload a letter of support from a member of the C-suite at your organization describing the commitment to the Schwartz Rounds program.

Optional: Please upload any additional materials to support your application.

By submitting this application, my organization agrees to:

a. Host a minimum of two Schwartz Rounds sessions within the first year of program implementation and six Schwartz Rounds sessions per year thereafter for the duration of each grant cycle

b. Have a Schwartz Center staff person observe and provide feedback for one Schwartz Rounds session within the first year of program implementation and every year thereafter
c. Collect and submit session and attendee summary data after each Schwartz Rounds session

I agree

Contact Information

© 2024 The Schwartz Center for Compassionate Healthcare

t. 857.282.0400
info@theschwartzcenter.org

Tax ID #04-1564655

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