In 1997, the Office of Public Health Practice was chartered at Northeast Ohio Medical University (NEOMED). Through this office, public health practitioners and academics have engaged in informal collaborations, formal collaborations, and formal agreements. Projects that have helped public health practitioners included a sanitarian preparation course, educational opportunities, and shared faculty arrangements. The academic programs have benefited through support in accreditation activities, teaching and precepting of public health and medical students, and advice on community-oriented curriculum. Formal affiliation agreements have been developed between the medical school and 5 local health departments, and public health practitioners have been given faculty appointments. Factors that have resulted in the longevity of Academic Health Department relationships through the Office of Public Health Practice include individuals dedicated to these relationships, agencies willing to support collaborative efforts, mutually beneficial activities, and a culture conducive to continued engagement.