Share Your Success!

Maryland Comprehensive Cancer Control Plan - Implementation Reporting Tool

This tool is designed to assist the Maryland Cancer Collaborative and the Department of Health and Mental Hygiene to collect success stories and records of the implementation of goals, objectives, and strategies from the Maryland Comprehensive Cancer Control Plan. The completion of this tool will assist staff to monitor and report on cancer prevention and control activities that are carried out in Maryland.

Please use the online form below to share a project related to a goal, objective, or strategy from the Plan that you would like to high-light, or download the PDF form to mail, fax, or email. Your project may be considered for future statewide recognition; if so, you will be contacted for more information.

This form was completed by:

Date Submitted:

Program/Organization:

Contact E-mail:

Contact Phone:

Project Name:

Projective Objectives:

 Relevant Cancer Plan Chapter:

Relevant Cancer Plan Goal/Objective:

Relevant Cancer Plan Strategy:

Strategy is: Ongoing A one-time event

Strategy status as of (insert date):
Not achieved
Partially achieved
Fully achieved
Other (explain):