Santa Rosa Memorial Foundation (a fundraising arm for St Joseph Health) recently came to us with a request for a change from prior Annual Reports. We were happy to take a tired old format and add new elements that provide a more pleasing aesthetic. More photos, pull quotes, financial charts, increased white space and graphic elements helped to refresh their 2018 report. Designing for St. Joseph Health often means utilizing style guides established by their corporate headquarters in southern CA. Being thoughtful of the guidelines and knowing when to flex a creative arm is an important balancing act. NSD has designed maps, newspaper/magazine ads and digital billboards under these constraints. We have also had the opportunity to design a few pieces with more freedom—the largest being a project for Synergy, a medical fitness center which offers a wide range of services from fitness and medical services to spa treatments.