Contact Request for Prevention Network Technical Assistance (TA)

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Information reported here will be used to match you with a TA provider. If you have any questions, please contact Ruth Schwendinger (ruths@preventionnetwork.org.) Someone from our team will call or email you at the contact point provided below to coordinate assistance.

Email *

Please state your first and last name. *

What is your phone number? *

Please name the individual or organization (if different) who is requesting TA.

Are you associated with or a current member of a Prevention Network Program? (choose just one)

What is your primary request?

Do you want assistance working with a certain demographic of the population? *

Is there another topic or area in which you are seeking technical assistance?

List any accommodations needed for you to fully participate in receiving technical assistance.

Thank you!

We look forward to talking with you soon.

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