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REQUEST FORM: HEALTH CARE AND HUMAN TRAFFICKING CURRICULUM ASSESSMENT TOOL                     
The purpose of the Health Care and Human Trafficking Curriculum Assessment Tool is to:

          1) Evaluate existing training on human trafficking intended for health care professionals in Canada;

          2) Identify gaps in information that could assist with future educational development pertinent to the
              intersection of human trafficking and health care;

          3) Assist those designing training on human trafficking for health professionals.

Please note: The Health Care & Human Trafficking Curriculum Assessment Tool will be sent to the email you provide below. Shortly after you submit this form, you will receive an automatic email with a link to a PDF version of the assessment tool. The link may not work on all computers (depending on browser settings and permissions) and if you are unable to access the toolkit via the link, email: hthalliancecan@gmail.com

If you do not receive the tool within 1-2 business days, please check your spam folder.  Do NOT forward or duplicate the toolkit without express permission of the Human Trafficking Health Alliance of Canada.
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The information you provide here will be used for follow-up and evaluation purposes only.

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Last Name *
First Name *
What is your primary organizational affiliation? *
City & Province/Territory *
Country *
Role(s) - Check all that apply *
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Are you part of the Human Trafficking Health Alliance of Canada? *
Want to join the Human Trafficking Health Alliance of Canada!  
Visit our Website at: www.hthealthalliancecanada.org and complete the Google Form!
Thank you! 
Should you have any questions please email the Hthalliancecan@gmail.com
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