FHPCA Hospice Provider Members are different:About FHPCA Hospice Provider Membership:

» 97% of Florida’s Hospice Providers are members of FHPCA » Every Hospice Provider Member has a seat on FHPCA’s Board of Directors » Every employee of a provider member is a member of FHPCA » Partnering with FHPCA means you can reach key leaders and hundreds of clinicians

Florida Hospice Provider demographics: » 40% of the 20 largest hospice programs in the country are members of FHPCA » Average Daily Census ranges from 20 –1,500 » Innovative programs with varying needs » All provide some kind of ancillary service for patients and families

Three reasons you should become an Affiliate of FHPCA:

Expanding Your Reach: Becoming a member with FHPCA means you have the opportunity to reach 97% of the hospice programs that are operating within the state of Florida. Together theses programs hire thousands of employees consisting of nurses, physicians, social workers, chaplains, compliance officers, among many others.

Gaining the Tools for Success: We value our Affiliate Members and work hard to bring value to you and your company. We do this by offering multiple marketing and sponsorships opportunities that will help your company succeed in reaching your target audience. Along with the tools we have already prepared, we are also open to exploring new and different ideas to help you achieve your business goals.

Showing You Care: As an Affiliate Member of FHPCA, you have an opportunity to show hospice providers, hospice patients and their families your support for hospice and palliative care in Florida. Our hospice provider member programs are some of the largest and most respected in the country, caring for more than 100,000 patients a year and touching countless family members and loved ones.

“Our organization has been a Patron Associate Member of FHPCA for 9 years. We’ve seen great value in the partnership, and appreciate the opportunities the affiliation has afforded us. The staff runs events smoothly, and the hospice members are engaging. I recommend FHPCA to other potential Affiliates all the time.” -Rob Goodsell, Home Healthcare Solutions

Affiliate Membership

Program

2017 FHPCA AFFILIATE MEMBERSHIP BENEFITS

Join FHPCA and expose your brand to hundreds of hospice clinicians and leaders from around the state. These hospice professionals are responsible for treating upward of 100,000 patients each year and work for some of the largest hospices in the country.

MEMBER BENEFITS Associate Patron Corporate

Patron

Face-to-face networking opportunities with hospice leadership ✔ ✔

Join FHPCA committees and serve along side FHPCA Hospice Provider Members ✔ ✔

Access to the complete member directory of FHPCA ✔ ✔ ✔

Highlighted in ‘Patron Spotlight’ in E-Newsletter, website, or on social media. ✔ ✔

Invitation to exhibit at FHPCA’s annual Forum & Tradeshow - additional fees apply ✔ ✔ ✔

Listed in FHPCA Member Directory - distributed to all Provider Members ✔ ✔ ✔

Listed as a member on FHPCA’s website ✔ ✔ ✔

Member Services support - Monday through Friday ✔ ✔ ✔

Year long advertising in E-Newsletter, on website landing page, and member login ✔

Subscription to bi-weekly E-Newsletter and Quarterly Affiliate E-Newsletter ✔ ✔ ✔

A chance to submit content to E-Newsletter – sent to all FHPCA board members ✔ ✔

Sponsorship opportunities throughout the year ✔ ✔

Promotion on FHPCA’s social media networks ✔

Opportunity to propose educational topics and/or faculty for online training webinars and/or annual Education Forum ✔ ✔

Discounted rates for advertising on website and E-Newsletter ✔ ✔ ✔

A digital member badge to use on your company’s website ✔ ✔ ✔

Affiliate Membership Application

Florida Hospice & Palliative Care Association (FHPCA) invites you to join the Affiliate Membership program. Your dollars contribute to our community based and directed hospice programs that provide so many extra services to their communities. Please complete and return this application and we will begin processing your membership. This application can be mailed, faxed, or e-mailed to our office based on your preferred method of payment.

EACH APPLICANT IS REQUIRED TO COMPLETE THIS FORM IN ITS ENTIRETY. IF NECESSARY, PLEASE USE “N/A” INSTEAD OF LEAVING BLANK LINES. ALL QUESTIONS CAN BE DIRECTED TO MEMBERSHIP SERVICES AT FHPCA BY CALLING (877) 783-1922 OR EMAILING HOLLY SINCO, MEMBER SERVICES COORDINATOR AT HOLLY@FLORIDAHOSPICES.ORG.

We recognize the highly confidential nature of some of this information. It will only be used by FHPCA in case of an emergency.

Business Name:

Mailing Address: Category: ¨ Corporate-Patron Associate Member¨ Patron Associate Member¨ Associate Member

Office Phone: Toll Free Phone: Fax:

Website:

Business Email:

Social Media: * Facebook* Twitter

* Google+* Blog ______________________________* Other _____________________________

I was referred by:

PRIMARY CONTACT: This person will receive all communications from FHPCA regarding events, news, renewals, etc.

Prefix: First: Last: Suffix:

Business Name (if different): Job Title:

Mailing Address (if different):

Work Phone: Cell Phone:

Email:

EVENT CONTACT: If the primary contact is not the person we should contact regarding an upcoming event, please provide that person’s information below.

Prefix: First: Last: Suffix:

Business Name (if different): Job Title:

Mailing Address (if different):

Work Phone: Cell Phone:

Email:

MARKETING CONTACT: This is person FHPCA should contact regarding promotion of your company through our various communications (i.e. blog, e-newsletter, website, etc.) Prefix: First:

Last: Suffix:

Business Name (if different):

Job Title:

Work Phone: Cell Phone:

Email:

BUSINESS CLASSIFICATION: (PLEASE CHECK ONLY ONE BOX)

Accreditation Consultant Durable Medical Equipment Foundation Insurance/Risk Management

Legal Services Medical Supply Pharmaceutical Publisher Research and Education

Software Vendor Staffing Agency/Service Other: ____________________________________________________

PLEASE READ AND SIGN:

FHPCA is an IRS 501(c)(3) charitable organization and contributions may be tax deductible as charitable donations (less 5% for lobbying activities) or allowable business expense. Please consult your tax advisor.

SIGNATURE OF PRIMARY CONTACT: __________________________________________________________ I understand that by providing my mailing address, e-mail, telephone number, and fax number, I consent to receive communications via regular mail, e-mail, telephone, and/or fax sent by or on behalf of FHPCA. I FURTHER UNDERSTAND THAT EVENTS SCHEDULED BY THE FHPCA BOARD OF DIRECTORS ARE BY INVITATION ONLY AND IN ORDER TO ATTEND ANY SUCH EVENTS I MUST REGISTER BY THE DEADLINE AND PROVIDE ALL REQUESTED INFORMATION. AS AN INVITED GUEST, I WILL HONOR THE AGENDA AS SET FORTH BY THE BOARD AND WILL NOT SCHEDULE CONFLICTING ACTIVITIES THAT MIGHT TAKE AWAY FROM THE AGENDA.

Corporate Patron Membership $12,500.00 Patron Associate Membership $2,500.00 Associate Membership $500.00

TOTAL INVESTMENT $ ___________.00 PAYMENT INFORMATION: Make checks payable to Florida Hospice & Palliative Care Association, Inc. Visa MasterCard Discover American Express Name on Credit Card: ______________________________________________________________________________________

Credit Card #: _____________________________________________________________________________________________

Expiration Date: ____________________________________________________ Code:__________________________________

Billing Address: ____________________________________________________________________________________________

In order for your application to be processed, please ensure all of the following are included in your submission:

1. ____ Payment 2. ____ Application:

a. ____ Completed & signed application b. ____ Company logo (.pdf format or high quality .jpeg) c. ____ Short (200 words or less) description of your business for use in the membership directory.

Please send all materials and invoice requests to Holly Sinco, Member Services Coordinator at holly@floridahospices.org.

Advertising and Sponsorships Opportunities

Sponsoring Below are some examples of the types of sponsorship opportunities available to our Affiliate Members. If you have a creative sponsorship in mind that is not listed below, we would happy to work with you to make it possible.

Board Meetings (Patron and Corporate-Patron Members only) – Direct your brand towards the key decision makers for hospice in Florida through any one of our sponsorship opportunities. Below are some examples of the sponsorships available.

Breakfast / Lunch / Dinner / Dessert / Cocktail | Executive Roundtable | Room Key Sponsor

Advertising The Hospice Executive E-Newsletter: This monthly publication is sent on the second Wednesday of each month to the FHPCA Board of Directors and subscribed leadership. All publications are archived on the internal Board of Directors membership portal. Only one ad spot is available per publication (twelve available for the year).

Price per ad, per issue: $200 for members / $250 for non-members.

Hospice Professional E-Newsletter: This monthly publication is sent on the third Thursday of each month to hospice professionals state and nationwide. We archive all E-Newsletters on our website, as well as promote the publication on all of our social media outlets for additional coverage. One ad per publication available.

Price per ad, per issue: $100 for members / $150 for non-members. Ad specifications: Image specifications: Files must be press ready and sent in .jpeg (RGB) or .png format. Files cannot be larger than 1MB. The image size for The Hospice Executive ad space is 260px (portrait), and 600px (landscape) for The Hospice Professional. Analytics will be provided for both publications.

Website Advertising: We have designed our website with you in mind by ensuring advertising space on all of our webpages. Some of our pages are designed to attract hospice program members, while others are of interest to the general public.

The ‘Location + Duration’ advertising option allows you to choose where and how long you want to advertise on FHPCA’s website. Simply use the formula below to decide which choice works best for you. Ads must be press ready and provided in .jpeg format. Your ads can be linked to your website or document. The ad space available is small, we recommend you limit the amount of words used.

Front Page (per ad) = $100 for members/$150 for non-members +

Duration: $25 per week

= Cost of Ad or Secondary Pages (per ad, per page) = $50 members/$75 non-members

Distribute Your Content & Be Involved [FOR FHPCA MEMBERS ONLY] The Hospice Voice Blog PATRONS AND CORPORATE PATRONS The Hospice Voice, our online blog, is a great way to reach the general public and FHPCA members that visit our website. Articles are focused on explaining hospice, palliative care, and end-of-life issues so the general public or healthcare professionals can have a clear understanding about these subject matters. Your company’s logo, website, and mission statement will appear at the bottom of each post you write. Articles submitted to the blog will also be posted in our monthly E-newsletter publication.

Article length: 500 words or less. Content parameters: No sales pitch, content should be educational only. FHPCA holds editor rights, and the ability to refuse content not related or deemed insufficient for the blog.

Hospice Professional E-Newsletter PATRONS AND CORPORATE PATRONS Our monthly hospice professional E-newsletter is sent to a variety of hospice employees and professionals from around the state and nation. Patron members can contribute news about their company, or can submit original articles on topics related to hospice, palliative care, and/or end-of-life. Does your company already publish original content? Submit your company’s original content to info@floridahospices.org for consideration in our E-Newsletter and online blog.

32nd Annual Forum Conference Exhibiting at Forum is a unique way to reach many types of hospice professionals from across the state of Florida and United States in one place. Sponsorships are also available as an opportunity to collaborate with FHPCA and stand out from the crowd. Increase your visibility and exposure through one of the many opportunities offered at this event.

May 25 – 26, 2017 – Hyatt Regency Grand Cypress Visit our Exhibitor & Sponsor Page for details

FHPCA Committees PATRON AND CORPORATE PATRONS Joining an FHPCA committee provides Affiliate Members a chance to work alongside hospice leaders and help further FHPCA’s mission of quality hospice in Florida. FHPCA integrates the involvement of our Board Members by requiring all to serve on at least one of our committees. This is a great opportunity to build lasting relationships through active involvement.

Committees available to Affiliate Members: § Research & Development Committee § Quality Indicators & Education Committee

Ê Forum Committee

Interested? Questions? Want More Information? Contact: Jessica Hughes, COO | P: 877-783-1922 | E: Jessica@floridahospices.org 2000 Apalachee Parkway | Suite 200 | Tallahassee, FL 32301 W: www.floridahospices.org