Risk Reduction Resource Kit Request Form
If your site qualifies to receive a Resource Kit, you will be placed on our waitlist and a HIFY Health Educator/Trainer will reach out to you as soon as your kit is ready to be delivered to your site
Name of Organization, Agency, or School *
Your answer
Name of Point Person *
Your answer
Position Title of Point Person *
Your answer
Phone Number of Point Person *
Your answer
Email of Point Person *
Your answer
How did you hear about our kits? *
Your answer
Address of the location to which the RRRK should be delivered *
Your answer
Number of Youth who use/pass through your space monthly? *
Your answer
What ages or grade levels does your site support? *
Your answer
How would this kit support your youth? *
Your answer
Where at your site would this Resource Kit be located? *
Your answer
What are the factors contributing to the need for this material? In other words, why are these resources not already present in the space? *
Required
Do you need everything that is included in the RRRK? *
If NOT, please let us know what you DON'T need
Your answer
Comments or Questions
Your answer
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