Winning an anesthesia services contract is not the end of the journey—it is the beginning of a new partnership that must be actively nurtured to succeed. This chapter provides a practical framework for anesthesia groups navigating hospital Requests for Proposal (RFPs), from understanding the motivations behind an RFP to executing a seamless post-award transition. It emphasizes that success in this process depends on strong communication, strategic positioning, and a clearly articulated value proposition that aligns with institutional goals. The chapter offers step-by-step guidance on evaluating RFP triggers, preparing competitive proposals, engaging consultants, and conducting an honest assessment of organizational strengths and weaknesses. Post-award, it details the essential processes for onboarding, relationship-building, and establishing structured communication between anesthesia leadership and hospital administration. By outlining strategies such as quarterly leadership reviews, monthly operational meetings, and transparent performance reporting, the chapter underscores that partnership longevity depends on accountability, adaptability, and mutual trust. Ultimately, anesthesiologists who approach the RFP process as an opportunity for collaboration—rather than confrontation—can transform a transactional contract into a sustainable, high-value relationship.