SOCIAL PRESCRIPTION FORM

Interested in adding your organization to the list?  Fill out the form!

This list is for ongoing programs that meet regularly, NOT one-off events.

This information has been volunteered by the organizations themselves or pulled from publicly available resources.  I invite you to join my efforts to better connect health professionals, their clients, and the larger community.  This is a free, open access, crowd sourced reference - there is no cost or expectation of any affiliation between organizations, just a way for more people to know what you have to offer.  If you have any questions, concerns, or ideas please do not hesitate to contact me at [email protected].

QUESTION BY QUESTION TIPS

  1. Email: use the email of the person most likely to be available during the program, this person will be responsible for communication with interested parties
  2. Organization: your main organization, NOT the program:  Omaha Public Library, or Ollie Webb
  3. Program: Specific name of the program you are offering: Chew N Chat Book Club
  4. Contact Person: use the person’s email entered above
  5. Phone number: make sure to use publicly available numbers and NOT private cell phones.  This information will be on a published website accessible to anyone.
  6. Type of Program: 
    1. Volunteer Opportunity - adults and adolescents helping out, with minimal supervision or programming.  I.e. archival, maintenance, litter
    2. Class (leader facilitated activity) - requires a leader to facilitate the group or teach new skills: library storytime, Master Naturalist 
    3. Club (peer led activity) - while the group may be facilitated by a leader, the group will be more egalitarian and open to discussion: book clubs, knitting groups
    4. Drop In Space (e.g. Open Studio) - no program requirements or staff facilitation: open studio, drop-in repair shop
  7. Five needs met with social prescriptions:
    1. Nature - hiking, gardening, bird watching, spending time in green or blue spaces
    2. Movement - physical activity, walking, biking, jogging, swimming, dance
    3. Art in all its forms - poetry, writing, reading, visual arts, music, dance
    4. Service - community based volunteering, helping others
    5. Belonging or Connection - social inclusion, people enjoying each other, finding friends

  8. Short description of the program: a few sentences describing what your program does and who might enjoy it
  9. When does your program occur?: This list is for ongoing programs with open enrollment.  Include time starting, time ending, and what day of the week.  Specify once a week, every other, what week of the month, etc.
  10. Registration: What do potential participants need to do before they come to your program?
  11. Age groups: If your program serves children, please include how much caregiver participation will be required in the "other information" question at the end of the form.
  12. Demographics: this is an optional question, for any programs who have specific populations in mind.  The philosophy of social prescription is based on health equity, which must include an anti-racist and anti-oppression focus.
  13. Presenting issues: this is also an optional question, echoing the ethos of health equity
  14. Cost: free and low cost programs are preferred
  15. Financial support: how do you ensure money is not a barrier to engaging with your program?
  16. Platform
  17. Link, if applicable.  If in-person only please skip.
  18. Physical address of the program, if applicable.  If online please skip.
  19. Accessibility: ADA, mobility, and logistical accommodations
  20. More information: this is a great place to specify group rules, scheduling protocol, or anything you'd like potential participants to know
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