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Updated Drug Free Community Philadelphia Coalition Assessment

This survey is designed to help you:

1: Identify particular areas of need in the community you serve 
2: Establish capacity for your coalition.

1.Coalition Information
Please, provide the name of your coalition, the name of your contact person, the contact person's email address, and the zip codes your coalition will serve.
2.Please select the current community partnerships where these is an identified person(s) for collaboration.  Select all that apply.
3.Are the following currently in place within your organization/coalition? Select all that apply.
4.Select the resources your organization/coalition has access to.
5.Has your organization/coalition completed a community or needs assessment to identify resources.  If yes, please forward document to mheyward@pmhcc.org.
6.Please identify possible community concerns. Select all that apply.
7.Does your organization/coalition have knowledge of substance misuse challenges in the community/neighborhood?
8.Select problem substances.