Project Summary/Abstract This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA- 24-041. The Stanford Cancer Institute’s (SCI) mission is to leverage the broad and unique strengths of Stanford University in basic science, bioengineering, population science, biostatistics, technology development, clinical research, clinical care, and translation to (1) improve the diagnosis, treatment, and outcomes of cancer patients; (2) understand cancer etiologies among diverse populations; and (3) decrease cancer incidence in the SCI catchment area and beyond. SCI is committed to improving long-term outcomes by ensuring that cancer survivors have access to guideline concordant survivorship care, including timely referrals to supportive services and preventative care. This proposal is designed to evaluate the alignment of survivorship care delivery within clinical care programs at the Comprehensive Cancer Center in Palo Alto and network sites, with the National Standards for Cancer Survivorship Care. In partnership with operational leaders and project managers at Stanford Healthcare, we will use a mixed methods approach to leverage data that exist in the electronic medical record, cancer center registry, institutional policies, and implementation projects; and supplement this by adding surveys and in-depth interviews with key informants and stakeholders. Integrated data analysis will inform a comprehensive report of the effectiveness and reach of Stanford’s Cancer Survivorship Program, alignment with the National Standards for Cancer Survivorship Care, and gaps and barriers to care delivery. Key findings will provide data to support the allocation of resources, customization of workflows and training of staff and healthcare professionals. Activities proposed in this research are highly aligned with the SCI’s commitment to understand and address gaps in survivorship care and will lead to research initiatives designed to test new models of care and interventions to improve physical, emotional, and mental health. Ultimately, this work aims to harmonize best practices across the Stanford network in line with national survivorship care standards, improve the quality of survivorship care, and thus enhance the long-term outcomes and well-being of all cancer survivors.