Overview

Clinic Application 
Thank you for your interest in the Texas-Youth Friendly Initiative (TYFI)! TYFI works to increase the number of youth (ages 10-24) accessing comprehensive health services by improving clinics' youth-friendliness. This model brings together teams from 6-8 clinics to form an innovative community of practice. Each cohort is guided through an evidence-based approach to remove barriers to change and streamline implementation for improved care delivery to adolescents. Together, we are working to improve the health of adolescents across Texas! 
Organization Information (please note that each clinic system may apply for one site to participate in this cohort).

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* 1. Organization Information (please note that each clinic system may apply for one site to participate in this cohort).

Organization Background:
Briefly describe your agency’s experience providing adolescent health services.

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* 2. Organization Background:
Briefly describe your agency’s experience providing adolescent health services.

Numbers of Clients Served:
Please indicate, by age, the number of unduplicated patients served by your agency (Fiscal Year 2017).

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* 3. Numbers of Clients Served:
Please indicate, by age, the number of unduplicated patients served by your agency (Fiscal Year 2017).

Motivation:
What do you hope to accomplish through your participation in this initiative (at the policy or direct service level)?

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* 4. Motivation:
What do you hope to accomplish through your participation in this initiative (at the policy or direct service level)?

Support Services and Programs: 
Please list a few of your programs/services that other clinics in cohort 3 may benefit from learning about (examples: integrated behavioral health, medical/case management, patient navigation, youth advisory council, health education and promotion, etc.).

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* 5. Support Services and Programs: 
Please list a few of your programs/services that other clinics in cohort 3 may benefit from learning about (examples: integrated behavioral health, medical/case management, patient navigation, youth advisory council, health education and promotion, etc.).

Professional Reference:

Please provide at least one reference from a project performed within the last 5 years that demonstrates your organization's ability to perform a proposed scope of work.

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* 6. Professional Reference:

Please provide at least one reference from a project performed within the last 5 years that demonstrates your organization's ability to perform a proposed scope of work.

Staff to lead site-level implementation of TYFI:

We recommend a multi-disciplinary team including: a provider, practice manager and 1-3 additional clinic staff members who can commit approximately three hours per month to the project.

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* 7. Staff to lead site-level implementation of TYFI:

We recommend a multi-disciplinary team including: a provider, practice manager and 1-3 additional clinic staff members who can commit approximately three hours per month to the project.

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