Request Form: Assessment Tool for Health Care Provider Human Trafficking Training
This tool is a collaboration between the Laboratory to Combat Human Trafficking (
) and HEAL Trafficking (HEALtrafficking.org). It builds on the HEAL Trafficking Training and Education Committee’s, “Introductory Training on Human Trafficking for U.S. Health Care Professionals: Essential Content, April 2018.”
The purpose of this tool is to assist those designing a basic training on human trafficking for health professionals:
1. to assess the degree to which the training is comprehensive
2. to identify areas for improvement
If you do not receive the assessment training tool within 1-2 business days, please check your spam folder. Do NOT forward or duplicate the toolkit without express permission of HEAL Trafficking. Thank you!
Email Address (NOTE: this is the email address we will email the tool to)
Phone Number (optional)
What is your primary organizational affiliation?
State (please use the two-letter abbreviation; e.g. Arizona = AZ)
Role(s) (check all that apply)
Advanced Practice Clinician (NP, CNW, PA)
Billing/Patient Financial Services
Community Health Worker
Counselor or other Mental Health Worker
Are you already part of the HEAL network?
If you are interested in becoming part of the HEAL network, please visit our website at healtrafficking.org to sign up!
Shortly after you submit this form, you will receive an automatic email with a link to a PDF version of the assessment tool. PLEASE NOTE: 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
. Thank you!
Also, just a reminder, the information you provide here will be used for follow-up and evaluation purposes only. If you have any questions, please contact
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