Sample Memorandum of Understanding
Author: North Georgia Health District
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This sample Memorandum of Understanding (MOU) is an example of an MOU used by a local health department to create a mutual agreement about patient care with an area medical care provider. This template can be tailored to another jurisdiction by addressing the yellow highlighted areas. In addition, this document can be used as a template for other types of MOUs, such as those between the local health department and a community-based organization.
Program: Community Health
Submitted Date: May 28, 2008 | Modified Date: Sep 30, 2025
Primary Toolkit: HIV/STI Toolkit | Secondary Toolkit: HIV/STI Toolkit
Jurisdiction:
Institution Type: LHD - County,
Keywords: Health Promotion and Health Education
