This sample Memorandum of Understanding (MOU) is an agreement that can serve as a mechanism to formalize the relationship between partner agencies with the common goal of optimizing health care delivery and the overall well-being of a shared target population. This sample template can be modified with agency or site-specific information.

This tool is part of “Establishing and Providing Effective Referrals for Clients: A Toolkit for Family Planning Providers” which supports Title X grantees’ ability to provide effective referrals to meet the needs of their clients.