Potential Sponsor

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Partner & Sponsor Inquiry Form

We collaborate with organizations aligned with Direct Primary Care, physician entrepreneurship, and patient-first healthcare. This form helps us determine fit and next steps.

Contact & Organization Info

Enter your Company name

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Primary Contact Name

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Role / Title in Organization

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Email Address

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Phone Number

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Organization Website

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Company Size

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DPC Experience & Alignment

What is you experience in the DPC ecossystem?

No experience, but interested

We actively work with DPC clinics

Some experience/ Learning phase

Which best describes your interest?

Education collaboration

Other

Product/ service collaboration

Sponsorship (financial)

Strategic partnership (non-financial or mixed)

Sponsorship / Budget Qualification

What is your budget?

$10,000+

$2,000 or less

$2,001 to $5,000

$5,001 to $10,000

On-going/ monthly support

How long are you looking to sponsor?

12 months+

3 months

6 months

One-time

Partnership (Non-Financial or Hybrid)

What type of partnership are you proposing?

Product trials or benefits for physicians

Podcast sponsorship in-kind

Other

Event collaboration

Educational resources

Content collaboration