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Please provide some basic information that will help us better understand your needs.

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* 1. Name / Best Phone number to reach you 

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* 2. Name of Bureau/Location

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* 3. My team/bureau is interested in the following support (please check all that apply):

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* 4. Optional Description of needs

Please provide responses to each of the following questions to begin our thinking together. This is not meant to be time-consuming for you. Brief responses are encouraged!

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* 5. Please describe your project or effort.

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* 6. Please tell us in which communities you seek to reduce disparate outcomes:

Communities could be geographic, identity-based, or stem from additional factors.

Examples of communities are: disability and mental health, race, housing status, immigrant and refugee, religious, ethnic, and LGBTQIA+ identity communities, etc.

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* 7. What is your ideal timeline? 

Please note that Adapt to Impact must prioritize efforts that change the way community engagement happens. Short or "emergency" timelines are not conducive to this kind of change. 

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* 8. What would a successful outcome look like?

As part of beginning our work with you, we'll have a conversation with you that will help us better understand what kinds of support you'll need to be successful.

Part of that conversation will be talking about what your processes (for efforts like this) have been like  in the past, what they are now, and what you would like them to be in the future. 

We are mentioning it now because we recognize it's a big question! We want to give you time to reflect and gather any information you might need for the conversation.

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* 9. How did you hear about Adapt to Impact?

Thank you for your interest in working with Adapt To Impact. We look forward to working with you to transform the way government engages with communities on decisions.
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