Technical Assistance Request Form
How can Healthy Start EPIC Center support my program's success?
The Healthy Start EPIC Center provides free training and technical assistance (TA) to support Healthy Start grantees in achieving program goals to reduce infant mortality, reduce health disparities, and improve birth outcomes. Training and TA are mutually reinforcing capacity building activities. Training strives to build staff core competencies and organizational capacities to effectively provide Healthy Start services. TA provides for free, in-depth assistance in a focused area to an individual grantee or group of grantees, with an eye toward practical application of evidence-based practices targeting Healthy Start performance measures. Training and TA are offered through various modalities, including conferences, regional meetings, webinars, phone consultations, Communities of Practice, and Learning Collaboratives.
What happens after I submit this TA request?
You will be contacted within two business days by email or phone by your region's Technical Assistance Coordinator to schedule a time to discuss your TA request in greater detail. A TA Provider will be identified to work closely with you until the TA is complete. You and your TA Provider will develop a TA Work Plan that will capture what you want to accomplish, by when and the activities that will achieve this goal.
Name *
Your answer
Email address: *
Your answer
Best phone number to reach you:
Your answer
Healthy Start Project Name *
Your primary Healthy Start role: *
If you are not the project director, what is your Healthy Start project director's name and email address?
Your answer
Who is your Healthy Start federal Project Officer?
For which Healthy Start performance measure or programmatic area are you primarily requesting TA?
Please give us a brief description of the reason you are requesting TA.
Your answer
What prompted you to submit this TA request?
Please click submit below. Thanks for your TA request, and we look forward to connecting with you within 2 business days!
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