NOVA's Addiction Community Screening Request Form
Thank you for your interest in hosting a screening of NOVA’s Addiction. Opioid addiction is impacting communities all over the country, and hosting a community screening can be a crucial first step in educating the public about the impact of the opioid crisis, the science of addiction, and the most successful forms of treatment.

Our goals for community screenings are:

• Educating the public about the science of addiction and how opioids impact the brain.

• Changing the conversation around addiction to reduce language and attitudes that perpetuate stigma and prevent people from seeking treatment.

• Providing resources to communities and families that are currently struggling with addiction.

Please review the information and guidelines here for hosting an Addiction screening event and then complete the request form below. We'll review it and send you a community screening toolkit and a DVD copy of the film.

Screening guidelines and information:

• A calendar of all screening events will be made available on the Decoding the Weather Machine screening site.

• Your school/organization agrees to update NOVA Education about event attendance as well as any key changes in your event plans.

• No admission may be charged for your screening event.

• NOVA Education will keep you informed about community screenings for possible partnership opportunities.

• If you are planning to partner with a community organization, please note this in the form. The toolkit will include resources and tips to aid you in event planning.

• The film will be available to stream online after broadcast. We will also be able to send out DVD copies of the film to 100 venues. Please indicate in the form below if you would like a DVD copy of the film.

Thank you again for your interest in NOVA's Addiction. Please contact us if you have any questions!

Gina Varamo | 617-300-2342 | gina_varamo@wgbh.org
Name of School/ Organization *
Your answer
Name of Organizer *
Your answer
E-mail Address *
Your answer
Phone Number *
Your answer
Date of Screening (After November 10) *
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Name of Screening Venue *
Your answer
Street Address (to receive toolkit) *
Your answer
City, State, and Zip Code (to receive toolkit) *
Your answer
Are you partnering with another organization to host this event? *
If YES, please list the partner(s)
Your answer
Projected Attendance
Your answer
Target Audience (i.e. K-12 students, college students, adults, policymakers, etc.) *
Your answer
I would like a DVD copy of the film for my screening *
By submitting this form, you confirm that you are representing your organization and, on behalf of it, have read and understood the guidelines for hosting a screening, and that your school/organization agrees to them. *
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