APHC Assistance Request

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Note: The APHC program in its current form will end on June 30th, 2024. We cannot guarantee that projects requested after April 4th, 2024 will be completed. Our staff will work closely with you to provide detailed status updates, discuss next steps, and ensure a smooth handover process for any outstanding work.

If you are interested in receiving assistance from the APHC, please fill out the form below. We will contact you as soon as possible to schedule an introductory virtual meeting. You will meet with a member of the APHC team to discuss deliverables, scope of work, and timeline.

Email *

What is your name? *

What local MA health department(s) are you affiliated with? *

What is your role at your department/organization? *

What is the best phone number to reach you? *

What is the best email to reach you? *

Please confirm your email from above.

How did you hear about the APHC?

What best describes the type of assistance you need for your community? *

Please select your highest need. This list is not exhaustive - we are happy to work with you to tailor our work to your needs.

Communication (e.g. flyers, material development, social media assistance, press-releases)

Data support (e.g. quantitative analysis, map creation, data visualization)

Equity support (e.g. reaching out to community based orgs, strategy, program design)

Administrative support (e.g. meeting minutes, digital file organization, planning)

Other:

Please give a short summary of the project that you would like assistance with. *

If you are unsure of a specific project you would like us to do, please describe the problem you are hoping to have help solving.

Considering the needs you described above, what goal or result are you most hoping to achieve? *

Is there anything else you would like to share of how the APHC or MHOA could assist you?

A copy of your responses will be emailed to the address you provided.

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