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Direct Care Workforce Strategies Center - On Demand Technical Assistance Questionnaire
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1.
First Name
(Required.)
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2.
Last Name
(Required.)
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3.
Email
(Required.)
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4.
Phone Number
(Required.)
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5.
State Name
(Required.)
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6.
State Agency
(Required.)
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7.
What specific challenges or questions do you have that you are requesting technical assistance to address?
(Required.)
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8.
Are there key deadlines (e.g. legislative session, grant submission, leadership briefing) driving this request? If yes, please provide detailed explanation
(Required.)
9.
Is there a specific milestone(s) you are hoping to achieve as a result of receiving the requested TA? If so, please explain.
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10.
What resource(s) or deliverables are you hoping to gain as a result of the technical assistance received?
(Required.)
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11.
Who will participate in the TA process (agencies, divisions, external partners)?
(Required.)
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12.
What is your desired timeline for receiving the technical assistance requested? [Please Note that most TA requests are completed within 10-14 days and no later than 45 days from the original TA request submission date.]
(Required.)
13.
Please share any additional context or information that would help us better understand your request.
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14.
How did you hear about this opportunity
(Required.)
NGA
NASWA
PHI
UMN
CHCS
NACDD
NCIL
ACL
NCOA
Other
Other (please specify)
