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Proposal Request Form

Proposal Request Form

Organization Details

Fiscal Year End Date
Month
Day
Year

Services of Interest

Multi choice

Timeline Preferences

Ideal Start Date
Month
Day
Year
Target Completion Date
Month
Day
Year
Have you completed any of the following in the past 3 years?

Authorization

Are you the authorized decision-maker for contracting?
Yes
No – Please list who we should include:

Ascendant Healthcare Partners

3001 North Davis Highway, Suite Box 6028,

Pensacola, FL 32503

(850) 972-2471

Ascendant Healthcare Partners is a NACCHO Affiliate Partner
Ascendant Healthcare Partners named 2030 Healthy People Champion by HHS

© 2025 by Ascendant Healthcare Partners.

American Public Health Association with Ascendant Healthcare Partners
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