Cancer Coalition of North Texas (CCNT)

Community Cancer Coalition Contact Information

Community Cancer Coalition Name:

Address Line 1:

Address Line 2:

City:

Zip Code:

Name of Coalition Coordinator/Public Contact:

Coordinator Title:

Coordinator's Salute
(Example: Dr. Smith):

Telephone (main):

Additional Phone:

Toll Free Phone:

FAX
(not displayed on Web):

Internet E-mail Address:

Web Address:

General Information

Does your coalition have a regular chair?:

If yes, please complete the following:

Name of Coalition Chair:

Chair Title:

Chair's Salute
(Example: Dr. Smith):

Is your community cancer coalition a subgroup of a larger health coalition?:

If yes, please specify name of health coalition:

Approximately how many members are part of your cancer coalition?:

List Organizations/Agencies whose representatives are members of your cancer coalition.

Year Coalition Started:

Cancer Coalition Vision/Mission:

Coalition's Major Activities and/or Accomplishments During the Past Year:

Do you have data specific to your community that you use in planning your activities?:

If yes, source of data:

Geographic Areas Served in Texas

Does your coalition represent all counties in Texas?:

---- Texas Counties ----

Texas CancerPlan Goals and Objectives Addressed by Your Coalition

Goal I: Prevention Information and Services

Objective A: Increase availability of effective cancer prevention materials and programs.

Objective B: Increase awareness of and access to cancer prevention services.

Objective C: Promote healthy lifestyles and behaviors in children, particularly those at high risk for developing cancer, such as ethnically and culturally diverse populations and the medically underserved.

Objective D: Promote policies and programs aimed at reducing tobacco use and exposure to second hand smoke.

Objective E: Promote policies aimed at addressing cancer risk related to obesity.

Objective F: Increase awareness of and protection from carcinogens in the environment.

Goal II: Early Detection and Treatment

Objective A: Increase appropriate utilization of effective cancer screening services.

Objective B: Increase access to and appropriate utilization of cancer screening, diagnositc, treatment, and support services.

Objective C: Enhance quality of cancer screening, diagnostic, treatment, and support services.

Goal III: Professional Education and Practice

Objective A: Enhance health professionals' knowledge, skills, and practices regarding cancer prevention, early detection, treatment, support services, and survivorship.

Objective B: Address health professional workforce issues to adequately serve all Texans' cancer health needs.

Goal IV: Cancer Data Acquisition and Utilization

Objective A: Enhance existing cancer data systems to fully support the needs of Texas health care professionals, policy makers, planners, researchers, and the general public.

Objective B: Utilize quality data to support outcome-driven cancer control planning and utilization.

Goal V: Survivorship

Objective A: Increase knowledge of survivorship issues for the general public, cancer survivors, health care professionals, and policy makers.

Objective B: Increase the availability of effective programs and policies addressing cancer survivorship.

Objective C: Increase access to quality care and services for cancer survivors in Texas.

Most Recent Update Received on