ALL Together Technical Assistance Request

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ALL Together works to build capacity of and best practices in prevention, intervention, treatment and recovery of substance misuse and suicide in the Upper Valley. Anyone requesting technical assistance must attend a minimum of 3 ALL Together meetings per year.

Our goal in offering assistance is to support you in developing, implementing, and sustaining these efforts in the region. We kindly ask that any ALL Together assistance requests be formally submitted through this form. Please provide a minimum of three weeks notice to ensure staff time, quality of work and appropriate turn around.

Please enter one request per form. All requests will be reviewed by ALL Together staff for approval before assistance can be provided. Request will be approved within 10 business days. Contact ALL Together with questions by emailing info@uvalltogether.org.

Everyone who receives technical assistance will be asked to fill out an evaluation form.

Thank you for your interest in reducing the harms of substance misuse and suicide in the Upper Valley Region.

Contact Name:

Organization/Company:

Email:

Phone:

City, State:

Are you an ALL Together member?

Yes

Clear selection

Are you a local coalition member?

Yes

Clear selection

If yes, which local coalition?

Substance use focus of training:

Prevention (avoid or reduce the risk of developing a substance use disorder)

Intervention (skills for recognizing substance use disorders & how to address them)

Treatment (services are for people diagnosed with a substance use disorder)

Recovery (support individuals’ abilities to live productive lives and can often help with abstinence)

Other:

Clear selection

What is the purpose of your technical assistance request?

Who is the target audience of your technical assistance request?

What is the intended outcome of your technical assistance request?

What background information do we need to have?

What is the final produce needed?

When is the final product needed?

YYYY

What work will you be responsible for in this request?

What support do you need from AT staff for completion of this request?

How is your request related to the work of ALL Together?

Other comments:

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