This exemplar provides a completed example of the EPT health-related social needs screening and linkage deliverable. It demonstrates how a practice can document HRSN screening processes, staff roles, screening tools, referral pathways, closed-loop referral tracking, community partnerships, and performance monitoring. The example also shows how to report baseline and current data, describe implementation activities, identify workflow or data limitations, and present quantitative and qualitative results. Practices may use this resource as a reference when preparing their own submission but should provide responses that reflect their organization’s patient population, workflows, data, partnerships, and implementation experience.