Community Collaborator Registry

Thank you for expressing a desire to become a Community Collaborator with the University of Nebraska Medical Center and its affiliated Great Plains IDEA -CTR research network. This survey should take no longer than 5 minutes to complete.

The UNMC Office of Community Engagement serves as a hub, connecting partner needs with expertise and resources. The Great Plains IDeA-CTR Network pairs research needs to academic institutions in the Great Plains region.

By completing the survey, you are indicating that you are willing to be entered into this registry.

Our Community Engagement Coordinator will contact you shortly after the survey is completed to further assess how we can work together to create a healthier, safer communities. Thank you for connecting with us!

Please provide your name:
Name of your organization/group:
The title that you hold at this organization:
Your email address:
Briefly describe the primary goal or mission of your organization:
Does your organization typically serve a specific population? Specific geographic area? Please indicate:
Which health topic are you or your organization interested in addressing:
If you selected "other" what health topic are you interested in addressing:
Please indicate your preferred level of engagement with us:
If you selected "other" please indicate your desired collaboration with UNMC or its affiliated research network:
If you selected "collaborate with a researcher" as your desired collaboration, would you be willing to work with partner with institutions outside of your local area that are affiliated with the UNMC's regional community research group?
Thank you for participating in our survey. Please hit the "next" and "submit for approval" buttons to complete this entry. Once you have submitted the form, we will reach out to you using your provided contact information to address your request for collaboration.