* 1. How interested are you or your organization in conducting an Health Impact Assessment?

* 2. How do you plan on using Health Impact Assessment to support your work?

* 3. How, at this point, would you fund an Health Impact Assessment?

* 4. How interested are you or your organization in hiring HEP to support with Health Impact Assessment capacity building (training, technical assistance, etc) services?

* 5. Based on reading a description of our offerings, what type of Health Impact Assessment services would be MOST helpful? Please select no more than three.

* 6. How, at this point, would you pay for Health Impact Assessment capacity building services?

* 7. What additional questions do you have for us at this time regarding our Health Impact Assessment services?

* 8. Who else might be interested in learning more about Health Impact Assessment capacity building services? Please list organizations or interested community members here.

* 9. Name and organization (optional)

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