Team Edit Partnership Menu of Practices
Please complete an entry for each unique practice or program offered by your agency or school.

Please answer all the questions you can!  Blanks are okay if you do not know, and you can also resubmit a form with corrections or new ideas.

This information is brainstorming for a first draft-- we are a long way from final, so be as accurate as you can but please do not fret over minor gaps or inconsistencies. 


PRACTICES FOR NOW MEANS:  Any program you run, or event you might operate or service you could offer.  What is it your agency does? For an agency, it could be anything from anger management to a nutrition class to a mentoring program.  For schools- it could mean beyond the usual of reading & writing... maybe you offer Check in Check Out or a Food Pantry.  No wrong answers!  We are starting broadly and will narrow later on.

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Name of Agency *
Name of Department or Program (if applicable)
Name of Service, Intervention, Program or Practice (The thing you do!)
Brief Description
Tier of Intervention:  Is this primarily Tier 1 prevention/promotion, Tier 2 early intervention or Tier 3 individual intensive support, and please note if this is medical treatment.
Does this require a co-located position?
Clear selection
Does this practice require a referral?
Clear selection
What are the important enabling conditions and capacity? For example, would there need to be a 1.0 positions hired, or slots purchased or time-- how would someone obtain this service?  What does it take for this program to happen?
Is this a research based program or practice? 
Clear selection
Who is the correct contact to learn more about this practice? Please provide a name, title or both... bonus points for contact information!
Where can this practice occur?  Select that all that apply.
Who is served by this intervention? 
Are there any identified vulnerable populations that specifically benefit from this support? For example, low-income families, persons with disabilities, the elderly, people interacting with the criminal justice system, persons affected by violence, persons with addiction, etc. Please elaborate/clarify below.
Please describe your organization's ability to serve persons with special communication needs, if applicable. For example, visually- or hearing-impaired, non-English speaking, etc.
What else do we need to consider as we are mapping possible practices and programs?
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