ImpACTivista Collaborators

Thank you for trusting Impactivo and for your availability to partner with us in achieving our collective mission of transforming health systems.

We are renewing our consultant registry and are interested in updating your data. Specifically, we are interested in knowing:

- your interests and specializations
- how we can improve your experience as a consultant with Impactivo.

This information will allow us to create an updated profile and include you in our elite consultant registry in order to offer our clients and partners the best experience. Additionally, we appreciate your feedback on our work and how we can achieve a greater impact together.

The questionnaire should take between 15-20 minutes to fill out. Thank you again for your time and commitment to supporting this work.

Question Title

* 1. Contact information

Name:

Company (if applicable):

Address:

Email Address:

Phone Number:

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* 2. Preferred Method of Contact

E-mail

Phone call

Text

Question Title

* 3. Please indicate your level of interest in:

	Very interested	Somewhat Interested	Not interested
Providing subject matter expertise/consulting services	Providing subject matter expertise/consulting services Very interested	Providing subject matter expertise/consulting services Somewhat Interested	Providing subject matter expertise/consulting services Not interested
Providing training	Providing training Very interested	Providing training Somewhat Interested	Providing training Not interested
Participating in research projects	Participating in research projects Very interested	Participating in research projects Somewhat Interested	Participating in research projects Not interested
Receiving training from Impactivo	Receiving training from Impactivo Very interested	Receiving training from Impactivo Somewhat Interested	Receiving training from Impactivo Not interested
Participating in activities with Impactivo's network	Participating in activities with Impactivo's network Very interested	Participating in activities with Impactivo's network Somewhat Interested	Participating in activities with Impactivo's network Not interested
Open to employment opportunities	Open to employment opportunities Very interested	Open to employment opportunities Somewhat Interested	Open to employment opportunities Not interested
Collaborating in other initiatives	Collaborating in other initiatives Very interested	Collaborating in other initiatives Somewhat Interested	Collaborating in other initiatives Not interested

Question Title

* 4. Impactivo specializes in the implementation of evidence-based practices. Please let us know your level of expertise in each of the following areas:

	JEDI MASTER: You are a thought leader in this field.	EXPERT: You are passionate, knowledgeable and master this field.	PROFICIENT: You are knowledgeable but not motivated by work in this field.	APPRENTICE: You are interested in this field but need support before you can work independently.	NOT INTERESTED
Behavioral health integration	Behavioral health integration JEDI MASTER: You are a thought leader in this field.	Behavioral health integration EXPERT: You are passionate, knowledgeable and master this field.	Behavioral health integration PROFICIENT: You are knowledgeable but not motivated by work in this field.	Behavioral health integration APPRENTICE: You are interested in this field but need support before you can work independently.	Behavioral health integration NOT INTERESTED
Chronic disease management	Chronic disease management JEDI MASTER: You are a thought leader in this field.	Chronic disease management EXPERT: You are passionate, knowledgeable and master this field.	Chronic disease management PROFICIENT: You are knowledgeable but not motivated by work in this field.	Chronic disease management APPRENTICE: You are interested in this field but need support before you can work independently.	Chronic disease management NOT INTERESTED
Collective impact	Collective impact JEDI MASTER: You are a thought leader in this field.	Collective impact EXPERT: You are passionate, knowledgeable and master this field.	Collective impact PROFICIENT: You are knowledgeable but not motivated by work in this field.	Collective impact APPRENTICE: You are interested in this field but need support before you can work independently.	Collective impact NOT INTERESTED
Community health workers	Community health workers JEDI MASTER: You are a thought leader in this field.	Community health workers EXPERT: You are passionate, knowledgeable and master this field.	Community health workers PROFICIENT: You are knowledgeable but not motivated by work in this field.	Community health workers APPRENTICE: You are interested in this field but need support before you can work independently.	Community health workers NOT INTERESTED
Quality improvement	Quality improvement JEDI MASTER: You are a thought leader in this field.	Quality improvement EXPERT: You are passionate, knowledgeable and master this field.	Quality improvement PROFICIENT: You are knowledgeable but not motivated by work in this field.	Quality improvement APPRENTICE: You are interested in this field but need support before you can work independently.	Quality improvement NOT INTERESTED
Immunizations	Immunizations JEDI MASTER: You are a thought leader in this field.	Immunizations EXPERT: You are passionate, knowledgeable and master this field.	Immunizations PROFICIENT: You are knowledgeable but not motivated by work in this field.	Immunizations APPRENTICE: You are interested in this field but need support before you can work independently.	Immunizations NOT INTERESTED
Implementation sciences	Implementation sciences JEDI MASTER: You are a thought leader in this field.	Implementation sciences EXPERT: You are passionate, knowledgeable and master this field.	Implementation sciences PROFICIENT: You are knowledgeable but not motivated by work in this field.	Implementation sciences APPRENTICE: You are interested in this field but need support before you can work independently.	Implementation sciences NOT INTERESTED
Maternal/child health	Maternal/child health JEDI MASTER: You are a thought leader in this field.	Maternal/child health EXPERT: You are passionate, knowledgeable and master this field.	Maternal/child health PROFICIENT: You are knowledgeable but not motivated by work in this field.	Maternal/child health APPRENTICE: You are interested in this field but need support before you can work independently.	Maternal/child health NOT INTERESTED
Patient engagement	Patient engagement JEDI MASTER: You are a thought leader in this field.	Patient engagement EXPERT: You are passionate, knowledgeable and master this field.	Patient engagement PROFICIENT: You are knowledgeable but not motivated by work in this field.	Patient engagement APPRENTICE: You are interested in this field but need support before you can work independently.	Patient engagement NOT INTERESTED
Patient-centered medical home	Patient-centered medical home JEDI MASTER: You are a thought leader in this field.	Patient-centered medical home EXPERT: You are passionate, knowledgeable and master this field.	Patient-centered medical home PROFICIENT: You are knowledgeable but not motivated by work in this field.	Patient-centered medical home APPRENTICE: You are interested in this field but need support before you can work independently.	Patient-centered medical home NOT INTERESTED
Patient-centered specialty practice	Patient-centered specialty practice JEDI MASTER: You are a thought leader in this field.	Patient-centered specialty practice EXPERT: You are passionate, knowledgeable and master this field.	Patient-centered specialty practice PROFICIENT: You are knowledgeable but not motivated by work in this field.	Patient-centered specialty practice APPRENTICE: You are interested in this field but need support before you can work independently.	Patient-centered specialty practice NOT INTERESTED
Personalized care	Personalized care JEDI MASTER: You are a thought leader in this field.	Personalized care EXPERT: You are passionate, knowledgeable and master this field.	Personalized care PROFICIENT: You are knowledgeable but not motivated by work in this field.	Personalized care APPRENTICE: You are interested in this field but need support before you can work independently.	Personalized care NOT INTERESTED
Population health	Population health JEDI MASTER: You are a thought leader in this field.	Population health EXPERT: You are passionate, knowledgeable and master this field.	Population health PROFICIENT: You are knowledgeable but not motivated by work in this field.	Population health APPRENTICE: You are interested in this field but need support before you can work independently.	Population health NOT INTERESTED
Shared medical appointments/Group visits	Shared medical appointments/Group visits JEDI MASTER: You are a thought leader in this field.	Shared medical appointments/Group visits EXPERT: You are passionate, knowledgeable and master this field.	Shared medical appointments/Group visits PROFICIENT: You are knowledgeable but not motivated by work in this field.	Shared medical appointments/Group visits APPRENTICE: You are interested in this field but need support before you can work independently.	Shared medical appointments/Group visits NOT INTERESTED
Social determinants of health	Social determinants of health JEDI MASTER: You are a thought leader in this field.	Social determinants of health EXPERT: You are passionate, knowledgeable and master this field.	Social determinants of health PROFICIENT: You are knowledgeable but not motivated by work in this field.	Social determinants of health APPRENTICE: You are interested in this field but need support before you can work independently.	Social determinants of health NOT INTERESTED
Telehealth	Telehealth JEDI MASTER: You are a thought leader in this field.	Telehealth EXPERT: You are passionate, knowledgeable and master this field.	Telehealth PROFICIENT: You are knowledgeable but not motivated by work in this field.	Telehealth APPRENTICE: You are interested in this field but need support before you can work independently.	Telehealth NOT INTERESTED

Other (please specify)

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* 5. Impactivo leads and supports various research projects. Please let us know your level of expertise in the following:

	JEDI MASTER: You are a thought leader in this field.	EXPERT: You are passionate, knowledgeable and master this field.	PROFICIENT: You are knowledgeable but not motivated by work in this field.	APPRENTICE: You are interested in this field but need support before you can work independently.	NOT INTERESTED
Community Health Needs Assessments	Community Health Needs Assessments JEDI MASTER: You are a thought leader in this field.	Community Health Needs Assessments EXPERT: You are passionate, knowledgeable and master this field.	Community Health Needs Assessments PROFICIENT: You are knowledgeable but not motivated by work in this field.	Community Health Needs Assessments APPRENTICE: You are interested in this field but need support before you can work independently.	Community Health Needs Assessments NOT INTERESTED
Biostatistics	Biostatistics JEDI MASTER: You are a thought leader in this field.	Biostatistics EXPERT: You are passionate, knowledgeable and master this field.	Biostatistics PROFICIENT: You are knowledgeable but not motivated by work in this field.	Biostatistics APPRENTICE: You are interested in this field but need support before you can work independently.	Biostatistics NOT INTERESTED
Community-based participatory research	Community-based participatory research JEDI MASTER: You are a thought leader in this field.	Community-based participatory research EXPERT: You are passionate, knowledgeable and master this field.	Community-based participatory research PROFICIENT: You are knowledgeable but not motivated by work in this field.	Community-based participatory research APPRENTICE: You are interested in this field but need support before you can work independently.	Community-based participatory research NOT INTERESTED
Design-based research	Design-based research JEDI MASTER: You are a thought leader in this field.	Design-based research EXPERT: You are passionate, knowledgeable and master this field.	Design-based research PROFICIENT: You are knowledgeable but not motivated by work in this field.	Design-based research APPRENTICE: You are interested in this field but need support before you can work independently.	Design-based research NOT INTERESTED
Epidemiology	Epidemiology JEDI MASTER: You are a thought leader in this field.	Epidemiology EXPERT: You are passionate, knowledgeable and master this field.	Epidemiology PROFICIENT: You are knowledgeable but not motivated by work in this field.	Epidemiology APPRENTICE: You are interested in this field but need support before you can work independently.	Epidemiology NOT INTERESTED
Educational research	Educational research JEDI MASTER: You are a thought leader in this field.	Educational research EXPERT: You are passionate, knowledgeable and master this field.	Educational research PROFICIENT: You are knowledgeable but not motivated by work in this field.	Educational research APPRENTICE: You are interested in this field but need support before you can work independently.	Educational research NOT INTERESTED
Financial modeling	Financial modeling JEDI MASTER: You are a thought leader in this field.	Financial modeling EXPERT: You are passionate, knowledgeable and master this field.	Financial modeling PROFICIENT: You are knowledgeable but not motivated by work in this field.	Financial modeling APPRENTICE: You are interested in this field but need support before you can work independently.	Financial modeling NOT INTERESTED
Health systems research	Health systems research JEDI MASTER: You are a thought leader in this field.	Health systems research EXPERT: You are passionate, knowledgeable and master this field.	Health systems research PROFICIENT: You are knowledgeable but not motivated by work in this field.	Health systems research APPRENTICE: You are interested in this field but need support before you can work independently.	Health systems research NOT INTERESTED
Implementation research	Implementation research JEDI MASTER: You are a thought leader in this field.	Implementation research EXPERT: You are passionate, knowledgeable and master this field.	Implementation research PROFICIENT: You are knowledgeable but not motivated by work in this field.	Implementation research APPRENTICE: You are interested in this field but need support before you can work independently.	Implementation research NOT INTERESTED
IRB approval	IRB approval JEDI MASTER: You are a thought leader in this field.	IRB approval EXPERT: You are passionate, knowledgeable and master this field.	IRB approval PROFICIENT: You are knowledgeable but not motivated by work in this field.	IRB approval APPRENTICE: You are interested in this field but need support before you can work independently.	IRB approval NOT INTERESTED
Mixed methods	Mixed methods JEDI MASTER: You are a thought leader in this field.	Mixed methods EXPERT: You are passionate, knowledgeable and master this field.	Mixed methods PROFICIENT: You are knowledgeable but not motivated by work in this field.	Mixed methods APPRENTICE: You are interested in this field but need support before you can work independently.	Mixed methods NOT INTERESTED
Patient-centered outcomes research	Patient-centered outcomes research JEDI MASTER: You are a thought leader in this field.	Patient-centered outcomes research EXPERT: You are passionate, knowledgeable and master this field.	Patient-centered outcomes research PROFICIENT: You are knowledgeable but not motivated by work in this field.	Patient-centered outcomes research APPRENTICE: You are interested in this field but need support before you can work independently.	Patient-centered outcomes research NOT INTERESTED
Program evaluation Randomized control trials	Program evaluation Randomized control trials JEDI MASTER: You are a thought leader in this field.	Program evaluation Randomized control trials EXPERT: You are passionate, knowledgeable and master this field.	Program evaluation Randomized control trials PROFICIENT: You are knowledgeable but not motivated by work in this field.	Program evaluation Randomized control trials APPRENTICE: You are interested in this field but need support before you can work independently.	Program evaluation Randomized control trials NOT INTERESTED
Survey design	Survey design JEDI MASTER: You are a thought leader in this field.	Survey design EXPERT: You are passionate, knowledgeable and master this field.	Survey design PROFICIENT: You are knowledgeable but not motivated by work in this field.	Survey design APPRENTICE: You are interested in this field but need support before you can work independently.	Survey design NOT INTERESTED
System Analysis	System Analysis JEDI MASTER: You are a thought leader in this field.	System Analysis EXPERT: You are passionate, knowledgeable and master this field.	System Analysis PROFICIENT: You are knowledgeable but not motivated by work in this field.	System Analysis APPRENTICE: You are interested in this field but need support before you can work independently.	System Analysis NOT INTERESTED
Qualitative research methods	Qualitative research methods JEDI MASTER: You are a thought leader in this field.	Qualitative research methods EXPERT: You are passionate, knowledgeable and master this field.	Qualitative research methods PROFICIENT: You are knowledgeable but not motivated by work in this field.	Qualitative research methods APPRENTICE: You are interested in this field but need support before you can work independently.	Qualitative research methods NOT INTERESTED
Quantitative research methods	Quantitative research methods JEDI MASTER: You are a thought leader in this field.	Quantitative research methods EXPERT: You are passionate, knowledgeable and master this field.	Quantitative research methods PROFICIENT: You are knowledgeable but not motivated by work in this field.	Quantitative research methods APPRENTICE: You are interested in this field but need support before you can work independently.	Quantitative research methods NOT INTERESTED

Other (please specify)

Question Title

* 6. Impactivo is developing health information technology tools for providers. Please let us know your level of expertise in the following:

	JEDI MASTER: You are a thought leader in this field.	EXPERT: You are passionate, knowledgeable and master this field.	PROFICIENT: You are knowledgeable but not motivated by work in this field.	APPRENTICE: You are interested in this field but need support before you can work independently.	NOT INTERESTED
Artificial intelligence	Artificial intelligence JEDI MASTER: You are a thought leader in this field.	Artificial intelligence EXPERT: You are passionate, knowledgeable and master this field.	Artificial intelligence PROFICIENT: You are knowledgeable but not motivated by work in this field.	Artificial intelligence APPRENTICE: You are interested in this field but need support before you can work independently.	Artificial intelligence NOT INTERESTED
Business intelligence	Business intelligence JEDI MASTER: You are a thought leader in this field.	Business intelligence EXPERT: You are passionate, knowledgeable and master this field.	Business intelligence PROFICIENT: You are knowledgeable but not motivated by work in this field.	Business intelligence APPRENTICE: You are interested in this field but need support before you can work independently.	Business intelligence NOT INTERESTED
Data Governance	Data Governance JEDI MASTER: You are a thought leader in this field.	Data Governance EXPERT: You are passionate, knowledgeable and master this field.	Data Governance PROFICIENT: You are knowledgeable but not motivated by work in this field.	Data Governance APPRENTICE: You are interested in this field but need support before you can work independently.	Data Governance NOT INTERESTED
Database management	Database management JEDI MASTER: You are a thought leader in this field.	Database management EXPERT: You are passionate, knowledgeable and master this field.	Database management PROFICIENT: You are knowledgeable but not motivated by work in this field.	Database management APPRENTICE: You are interested in this field but need support before you can work independently.	Database management NOT INTERESTED
HL7/FHIR	HL7/FHIR JEDI MASTER: You are a thought leader in this field.	HL7/FHIR EXPERT: You are passionate, knowledgeable and master this field.	HL7/FHIR PROFICIENT: You are knowledgeable but not motivated by work in this field.	HL7/FHIR APPRENTICE: You are interested in this field but need support before you can work independently.	HL7/FHIR NOT INTERESTED
Human-centered design	Human-centered design JEDI MASTER: You are a thought leader in this field.	Human-centered design EXPERT: You are passionate, knowledgeable and master this field.	Human-centered design PROFICIENT: You are knowledgeable but not motivated by work in this field.	Human-centered design APPRENTICE: You are interested in this field but need support before you can work independently.	Human-centered design NOT INTERESTED
Natural language processing	Natural language processing JEDI MASTER: You are a thought leader in this field.	Natural language processing EXPERT: You are passionate, knowledgeable and master this field.	Natural language processing PROFICIENT: You are knowledgeable but not motivated by work in this field.	Natural language processing APPRENTICE: You are interested in this field but need support before you can work independently.	Natural language processing NOT INTERESTED
Programming: C++	Programming: C++ JEDI MASTER: You are a thought leader in this field.	Programming: C++ EXPERT: You are passionate, knowledgeable and master this field.	Programming: C++ PROFICIENT: You are knowledgeable but not motivated by work in this field.	Programming: C++ APPRENTICE: You are interested in this field but need support before you can work independently.	Programming: C++ NOT INTERESTED
Programming: Javascript	Programming: Javascript JEDI MASTER: You are a thought leader in this field.	Programming: Javascript EXPERT: You are passionate, knowledgeable and master this field.	Programming: Javascript PROFICIENT: You are knowledgeable but not motivated by work in this field.	Programming: Javascript APPRENTICE: You are interested in this field but need support before you can work independently.	Programming: Javascript NOT INTERESTED
Programming: PHP	Programming: PHP JEDI MASTER: You are a thought leader in this field.	Programming: PHP EXPERT: You are passionate, knowledgeable and master this field.	Programming: PHP PROFICIENT: You are knowledgeable but not motivated by work in this field.	Programming: PHP APPRENTICE: You are interested in this field but need support before you can work independently.	Programming: PHP NOT INTERESTED
Programming: Python	Programming: Python JEDI MASTER: You are a thought leader in this field.	Programming: Python EXPERT: You are passionate, knowledgeable and master this field.	Programming: Python PROFICIENT: You are knowledgeable but not motivated by work in this field.	Programming: Python APPRENTICE: You are interested in this field but need support before you can work independently.	Programming: Python NOT INTERESTED
Programming: Go	Programming: Go JEDI MASTER: You are a thought leader in this field.	Programming: Go EXPERT: You are passionate, knowledgeable and master this field.	Programming: Go PROFICIENT: You are knowledgeable but not motivated by work in this field.	Programming: Go APPRENTICE: You are interested in this field but need support before you can work independently.	Programming: Go NOT INTERESTED
App Development	App Development JEDI MASTER: You are a thought leader in this field.	App Development EXPERT: You are passionate, knowledgeable and master this field.	App Development PROFICIENT: You are knowledgeable but not motivated by work in this field.	App Development APPRENTICE: You are interested in this field but need support before you can work independently.	App Development NOT INTERESTED

Other (please specify)

Question Title

* 7. Impactivo helps organizations fund and finance innovations in health. Please let us know your level of expertise in the following:

	JEDI MASTER: You are a thought leader in this field.	EXPERT: You are passionate, knowledgeable and master this field.	PROFICIENT: You are knowledgeable but not motivated by work in this field.	APPRENTICE: You are interested in this field but need support before you can work independently.	NOT INTERESTED
Federal grantwriting	Federal grantwriting JEDI MASTER: You are a thought leader in this field.	Federal grantwriting EXPERT: You are passionate, knowledgeable and master this field.	Federal grantwriting PROFICIENT: You are knowledgeable but not motivated by work in this field.	Federal grantwriting APPRENTICE: You are interested in this field but need support before you can work independently.	Federal grantwriting NOT INTERESTED
Federal grants management & compliance	Federal grants management & compliance JEDI MASTER: You are a thought leader in this field.	Federal grants management & compliance EXPERT: You are passionate, knowledgeable and master this field.	Federal grants management & compliance PROFICIENT: You are knowledgeable but not motivated by work in this field.	Federal grants management & compliance APPRENTICE: You are interested in this field but need support before you can work independently.	Federal grants management & compliance NOT INTERESTED
Fundraising campaigns	Fundraising campaigns JEDI MASTER: You are a thought leader in this field.	Fundraising campaigns EXPERT: You are passionate, knowledgeable and master this field.	Fundraising campaigns PROFICIENT: You are knowledgeable but not motivated by work in this field.	Fundraising campaigns APPRENTICE: You are interested in this field but need support before you can work independently.	Fundraising campaigns NOT INTERESTED
Medicaid policy	Medicaid policy JEDI MASTER: You are a thought leader in this field.	Medicaid policy EXPERT: You are passionate, knowledgeable and master this field.	Medicaid policy PROFICIENT: You are knowledgeable but not motivated by work in this field.	Medicaid policy APPRENTICE: You are interested in this field but need support before you can work independently.	Medicaid policy NOT INTERESTED
Medicare policy	Medicare policy JEDI MASTER: You are a thought leader in this field.	Medicare policy EXPERT: You are passionate, knowledgeable and master this field.	Medicare policy PROFICIENT: You are knowledgeable but not motivated by work in this field.	Medicare policy APPRENTICE: You are interested in this field but need support before you can work independently.	Medicare policy NOT INTERESTED
Policy analysis	Policy analysis JEDI MASTER: You are a thought leader in this field.	Policy analysis EXPERT: You are passionate, knowledgeable and master this field.	Policy analysis PROFICIENT: You are knowledgeable but not motivated by work in this field.	Policy analysis APPRENTICE: You are interested in this field but need support before you can work independently.	Policy analysis NOT INTERESTED
Value-based payments	Value-based payments JEDI MASTER: You are a thought leader in this field.	Value-based payments EXPERT: You are passionate, knowledgeable and master this field.	Value-based payments PROFICIENT: You are knowledgeable but not motivated by work in this field.	Value-based payments APPRENTICE: You are interested in this field but need support before you can work independently.	Value-based payments NOT INTERESTED

Question Title

* 8. Impactivo specializes in training and workplace culture. Please let us know your level of expertise in the following:

	JEDI MASTER: You are a thought leader in this field.	EXPERT: You are passionate, knowledgeable and master this field.	PROFICIENT: You are knowledgeable but not motivated by work in this field.	APPRENTICE: You are interested in this field but need support before you can work independently.	NOT INTERESTED
Industrial psychology	Industrial psychology JEDI MASTER: You are a thought leader in this field.	Industrial psychology EXPERT: You are passionate, knowledgeable and master this field.	Industrial psychology PROFICIENT: You are knowledgeable but not motivated by work in this field.	Industrial psychology APPRENTICE: You are interested in this field but need support before you can work independently.	Industrial psychology NOT INTERESTED
Instructional design	Instructional design JEDI MASTER: You are a thought leader in this field.	Instructional design EXPERT: You are passionate, knowledgeable and master this field.	Instructional design PROFICIENT: You are knowledgeable but not motivated by work in this field.	Instructional design APPRENTICE: You are interested in this field but need support before you can work independently.	Instructional design NOT INTERESTED
Leadership development	Leadership development JEDI MASTER: You are a thought leader in this field.	Leadership development EXPERT: You are passionate, knowledgeable and master this field.	Leadership development PROFICIENT: You are knowledgeable but not motivated by work in this field.	Leadership development APPRENTICE: You are interested in this field but need support before you can work independently.	Leadership development NOT INTERESTED
Organizational behavior	Organizational behavior JEDI MASTER: You are a thought leader in this field.	Organizational behavior EXPERT: You are passionate, knowledgeable and master this field.	Organizational behavior PROFICIENT: You are knowledgeable but not motivated by work in this field.	Organizational behavior APPRENTICE: You are interested in this field but need support before you can work independently.	Organizational behavior NOT INTERESTED
Patient Advocacy	Patient Advocacy JEDI MASTER: You are a thought leader in this field.	Patient Advocacy EXPERT: You are passionate, knowledgeable and master this field.	Patient Advocacy PROFICIENT: You are knowledgeable but not motivated by work in this field.	Patient Advocacy APPRENTICE: You are interested in this field but need support before you can work independently.	Patient Advocacy NOT INTERESTED
Team building	Team building JEDI MASTER: You are a thought leader in this field.	Team building EXPERT: You are passionate, knowledgeable and master this field.	Team building PROFICIENT: You are knowledgeable but not motivated by work in this field.	Team building APPRENTICE: You are interested in this field but need support before you can work independently.	Team building NOT INTERESTED
Workforce development	Workforce development JEDI MASTER: You are a thought leader in this field.	Workforce development EXPERT: You are passionate, knowledgeable and master this field.	Workforce development PROFICIENT: You are knowledgeable but not motivated by work in this field.	Workforce development APPRENTICE: You are interested in this field but need support before you can work independently.	Workforce development NOT INTERESTED
Workplace learning	Workplace learning JEDI MASTER: You are a thought leader in this field.	Workplace learning EXPERT: You are passionate, knowledgeable and master this field.	Workplace learning PROFICIENT: You are knowledgeable but not motivated by work in this field.	Workplace learning APPRENTICE: You are interested in this field but need support before you can work independently.	Workplace learning NOT INTERESTED

Other (please specify)

Question Title

* 9. Impactivo is growing and we are looking for consultants that help us grow with the high level of quality that our clients are used to. Please let us know your level of expertise in the following:

	JEDI MASTER: You are a thought leader in this field.	EXPERT: You are passionate, knowledgeable and master this field.	PROFICIENT: You are knowledgeable but not motivated by work in this field.	APPRENTICE: You are interested in this field but need support before you can work independently.	NOT INTERESTED
Branding	Branding JEDI MASTER: You are a thought leader in this field.	Branding EXPERT: You are passionate, knowledgeable and master this field.	Branding PROFICIENT: You are knowledgeable but not motivated by work in this field.	Branding APPRENTICE: You are interested in this field but need support before you can work independently.	Branding NOT INTERESTED
Client management	Client management JEDI MASTER: You are a thought leader in this field.	Client management EXPERT: You are passionate, knowledgeable and master this field.	Client management PROFICIENT: You are knowledgeable but not motivated by work in this field.	Client management APPRENTICE: You are interested in this field but need support before you can work independently.	Client management NOT INTERESTED
Commercialization in Puerto Rico	Commercialization in Puerto Rico JEDI MASTER: You are a thought leader in this field.	Commercialization in Puerto Rico EXPERT: You are passionate, knowledgeable and master this field.	Commercialization in Puerto Rico PROFICIENT: You are knowledgeable but not motivated by work in this field.	Commercialization in Puerto Rico APPRENTICE: You are interested in this field but need support before you can work independently.	Commercialization in Puerto Rico NOT INTERESTED
Commercialization in the US	Commercialization in the US JEDI MASTER: You are a thought leader in this field.	Commercialization in the US EXPERT: You are passionate, knowledgeable and master this field.	Commercialization in the US PROFICIENT: You are knowledgeable but not motivated by work in this field.	Commercialization in the US APPRENTICE: You are interested in this field but need support before you can work independently.	Commercialization in the US NOT INTERESTED
Commercialization Internationally	Commercialization Internationally JEDI MASTER: You are a thought leader in this field.	Commercialization Internationally EXPERT: You are passionate, knowledgeable and master this field.	Commercialization Internationally PROFICIENT: You are knowledgeable but not motivated by work in this field.	Commercialization Internationally APPRENTICE: You are interested in this field but need support before you can work independently.	Commercialization Internationally NOT INTERESTED
Development of policies and procedures	Development of policies and procedures JEDI MASTER: You are a thought leader in this field.	Development of policies and procedures EXPERT: You are passionate, knowledgeable and master this field.	Development of policies and procedures PROFICIENT: You are knowledgeable but not motivated by work in this field.	Development of policies and procedures APPRENTICE: You are interested in this field but need support before you can work independently.	Development of policies and procedures NOT INTERESTED
Facilitation of groups	Facilitation of groups JEDI MASTER: You are a thought leader in this field.	Facilitation of groups EXPERT: You are passionate, knowledgeable and master this field.	Facilitation of groups PROFICIENT: You are knowledgeable but not motivated by work in this field.	Facilitation of groups APPRENTICE: You are interested in this field but need support before you can work independently.	Facilitation of groups NOT INTERESTED
Feasibility studies	Feasibility studies JEDI MASTER: You are a thought leader in this field.	Feasibility studies EXPERT: You are passionate, knowledgeable and master this field.	Feasibility studies PROFICIENT: You are knowledgeable but not motivated by work in this field.	Feasibility studies APPRENTICE: You are interested in this field but need support before you can work independently.	Feasibility studies NOT INTERESTED
Management of policies and procedures	Management of policies and procedures JEDI MASTER: You are a thought leader in this field.	Management of policies and procedures EXPERT: You are passionate, knowledgeable and master this field.	Management of policies and procedures PROFICIENT: You are knowledgeable but not motivated by work in this field.	Management of policies and procedures APPRENTICE: You are interested in this field but need support before you can work independently.	Management of policies and procedures NOT INTERESTED
Market analysis	Market analysis JEDI MASTER: You are a thought leader in this field.	Market analysis EXPERT: You are passionate, knowledgeable and master this field.	Market analysis PROFICIENT: You are knowledgeable but not motivated by work in this field.	Market analysis APPRENTICE: You are interested in this field but need support before you can work independently.	Market analysis NOT INTERESTED
Marketting in Puerto Rico	Marketting in Puerto Rico JEDI MASTER: You are a thought leader in this field.	Marketting in Puerto Rico EXPERT: You are passionate, knowledgeable and master this field.	Marketting in Puerto Rico PROFICIENT: You are knowledgeable but not motivated by work in this field.	Marketting in Puerto Rico APPRENTICE: You are interested in this field but need support before you can work independently.	Marketting in Puerto Rico NOT INTERESTED
Marketting in the US	Marketting in the US JEDI MASTER: You are a thought leader in this field.	Marketting in the US EXPERT: You are passionate, knowledgeable and master this field.	Marketting in the US PROFICIENT: You are knowledgeable but not motivated by work in this field.	Marketting in the US APPRENTICE: You are interested in this field but need support before you can work independently.	Marketting in the US NOT INTERESTED
Marketting Internationally	Marketting Internationally JEDI MASTER: You are a thought leader in this field.	Marketting Internationally EXPERT: You are passionate, knowledgeable and master this field.	Marketting Internationally PROFICIENT: You are knowledgeable but not motivated by work in this field.	Marketting Internationally APPRENTICE: You are interested in this field but need support before you can work independently.	Marketting Internationally NOT INTERESTED
Partnership development/negotiations	Partnership development/negotiations JEDI MASTER: You are a thought leader in this field.	Partnership development/negotiations EXPERT: You are passionate, knowledgeable and master this field.	Partnership development/negotiations PROFICIENT: You are knowledgeable but not motivated by work in this field.	Partnership development/negotiations APPRENTICE: You are interested in this field but need support before you can work independently.	Partnership development/negotiations NOT INTERESTED
Process improvement	Process improvement JEDI MASTER: You are a thought leader in this field.	Process improvement EXPERT: You are passionate, knowledgeable and master this field.	Process improvement PROFICIENT: You are knowledgeable but not motivated by work in this field.	Process improvement APPRENTICE: You are interested in this field but need support before you can work independently.	Process improvement NOT INTERESTED
Program development	Program development JEDI MASTER: You are a thought leader in this field.	Program development EXPERT: You are passionate, knowledgeable and master this field.	Program development PROFICIENT: You are knowledgeable but not motivated by work in this field.	Program development APPRENTICE: You are interested in this field but need support before you can work independently.	Program development NOT INTERESTED
Project management	Project management JEDI MASTER: You are a thought leader in this field.	Project management EXPERT: You are passionate, knowledgeable and master this field.	Project management PROFICIENT: You are knowledgeable but not motivated by work in this field.	Project management APPRENTICE: You are interested in this field but need support before you can work independently.	Project management NOT INTERESTED
Public relations	Public relations JEDI MASTER: You are a thought leader in this field.	Public relations EXPERT: You are passionate, knowledgeable and master this field.	Public relations PROFICIENT: You are knowledgeable but not motivated by work in this field.	Public relations APPRENTICE: You are interested in this field but need support before you can work independently.	Public relations NOT INTERESTED
Sales	Sales JEDI MASTER: You are a thought leader in this field.	Sales EXPERT: You are passionate, knowledgeable and master this field.	Sales PROFICIENT: You are knowledgeable but not motivated by work in this field.	Sales APPRENTICE: You are interested in this field but need support before you can work independently.	Sales NOT INTERESTED
Strategic Planning	Strategic Planning JEDI MASTER: You are a thought leader in this field.	Strategic Planning EXPERT: You are passionate, knowledgeable and master this field.	Strategic Planning PROFICIENT: You are knowledgeable but not motivated by work in this field.	Strategic Planning APPRENTICE: You are interested in this field but need support before you can work independently.	Strategic Planning NOT INTERESTED
Supervisory skills	Supervisory skills JEDI MASTER: You are a thought leader in this field.	Supervisory skills EXPERT: You are passionate, knowledgeable and master this field.	Supervisory skills PROFICIENT: You are knowledgeable but not motivated by work in this field.	Supervisory skills APPRENTICE: You are interested in this field but need support before you can work independently.	Supervisory skills NOT INTERESTED
Workflow design	Workflow design JEDI MASTER: You are a thought leader in this field.	Workflow design EXPERT: You are passionate, knowledgeable and master this field.	Workflow design PROFICIENT: You are knowledgeable but not motivated by work in this field.	Workflow design APPRENTICE: You are interested in this field but need support before you can work independently.	Workflow design NOT INTERESTED

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* 10. Impactivo publishes high-quality reports and deliverables. Please let us know your level of expertise in the following:

	JEDI MASTER: You are a thought leader in this field.	EXPERT: You are passionate, knowledgeable and master this field.	PROFICIENT: You are knowledgeable but not motivated by work in this field.	APPRENTICE: You are interested in this field but need support before you can work independently.	NOT INTERESTED
Editing (English)	Editing (English) JEDI MASTER: You are a thought leader in this field.	Editing (English) EXPERT: You are passionate, knowledgeable and master this field.	Editing (English) PROFICIENT: You are knowledgeable but not motivated by work in this field.	Editing (English) APPRENTICE: You are interested in this field but need support before you can work independently.	Editing (English) NOT INTERESTED
Editing (Spanish)	Editing (Spanish) JEDI MASTER: You are a thought leader in this field.	Editing (Spanish) EXPERT: You are passionate, knowledgeable and master this field.	Editing (Spanish) PROFICIENT: You are knowledgeable but not motivated by work in this field.	Editing (Spanish) APPRENTICE: You are interested in this field but need support before you can work independently.	Editing (Spanish) NOT INTERESTED
Federal proposal writing	Federal proposal writing JEDI MASTER: You are a thought leader in this field.	Federal proposal writing EXPERT: You are passionate, knowledgeable and master this field.	Federal proposal writing PROFICIENT: You are knowledgeable but not motivated by work in this field.	Federal proposal writing APPRENTICE: You are interested in this field but need support before you can work independently.	Federal proposal writing NOT INTERESTED
Peer-reviewed journals (English)	Peer-reviewed journals (English) JEDI MASTER: You are a thought leader in this field.	Peer-reviewed journals (English) EXPERT: You are passionate, knowledgeable and master this field.	Peer-reviewed journals (English) PROFICIENT: You are knowledgeable but not motivated by work in this field.	Peer-reviewed journals (English) APPRENTICE: You are interested in this field but need support before you can work independently.	Peer-reviewed journals (English) NOT INTERESTED
Peer-reviewed journals (Spanish)	Peer-reviewed journals (Spanish) JEDI MASTER: You are a thought leader in this field.	Peer-reviewed journals (Spanish) EXPERT: You are passionate, knowledgeable and master this field.	Peer-reviewed journals (Spanish) PROFICIENT: You are knowledgeable but not motivated by work in this field.	Peer-reviewed journals (Spanish) APPRENTICE: You are interested in this field but need support before you can work independently.	Peer-reviewed journals (Spanish) NOT INTERESTED
Reports, white papers and other deliverables (English)	Reports, white papers and other deliverables (English) JEDI MASTER: You are a thought leader in this field.	Reports, white papers and other deliverables (English) EXPERT: You are passionate, knowledgeable and master this field.	Reports, white papers and other deliverables (English) PROFICIENT: You are knowledgeable but not motivated by work in this field.	Reports, white papers and other deliverables (English) APPRENTICE: You are interested in this field but need support before you can work independently.	Reports, white papers and other deliverables (English) NOT INTERESTED
Reports, white papers and other deliverables (Spanish)	Reports, white papers and other deliverables (Spanish) JEDI MASTER: You are a thought leader in this field.	Reports, white papers and other deliverables (Spanish) EXPERT: You are passionate, knowledgeable and master this field.	Reports, white papers and other deliverables (Spanish) PROFICIENT: You are knowledgeable but not motivated by work in this field.	Reports, white papers and other deliverables (Spanish) APPRENTICE: You are interested in this field but need support before you can work independently.	Reports, white papers and other deliverables (Spanish) NOT INTERESTED

Other (please specify)

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* 11. Impactivo is an innovative company that prides itself on using advanced methodologies in its communication, organizational management, tasks distribution, interaction processes and administration. Please let us know your level of comfort using the following methodologies.

	Very comfortable	Somewhat comfortable	Not comfortable
Virtual meetings	Virtual meetings Very comfortable	Virtual meetings Somewhat comfortable	Virtual meetings Not comfortable	Virtual meetings	Virtual meetings
Virtual huddles	Virtual huddles Very comfortable	Virtual huddles Somewhat comfortable	Virtual huddles Not comfortable	Virtual huddles	Virtual huddles
Project management software	Project management software Very comfortable	Project management software Somewhat comfortable	Project management software Not comfortable	Project management software	Project management software
Time tracking software	Time tracking software Very comfortable	Time tracking software Somewhat comfortable	Time tracking software Not comfortable	Time tracking software	Time tracking software
Productivity and collaboration tools	Productivity and collaboration tools Very comfortable	Productivity and collaboration tools Somewhat comfortable	Productivity and collaboration tools Not comfortable	Productivity and collaboration tools	Productivity and collaboration tools

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* 12. Please indicate your availability to work on consulting engagements:

Available to work on trainings

Available to work for less than 10 hours a month

Available to work for less than 10 hours a week

Available to work for more than 10 hours a week

Open to diveres arrangements depending on the project

Available to work full time

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* 13. What are you most excited about regarding being a consultant for Impactivo? Please provide an exhaustive response so we can learn more about your interests so we can strengthen our relationship.

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* 14. We really appreciate your perspective and feedback. Please share any ideas on how we can improve our business model to have a greater impact.

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* 15. Are there any projects and/or entrepreneurial ideas to remove barriers to health that you would like to partner on?

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* 16. Please upload your CV/Biosketch (using NIH/NSF Format)

Your CV/Biosketch will be used to evaluate your fit with Impactivo needs. This information will not be shared with third parties without your authorization. You can use this format, if appropriate: https://grants.nih.gov/grants/forms/biosketch.htm

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 17. Please upload your bio.

Your bio should be in english and one paragraph in length. By uploading your bio you are granting us permission to publish it on our website after assessing your fit with our team. You can see a sample bio on our website at: https://impactivo.com/about-us/

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 18. Please upload your picture.

By uploading your picture you are granting us permission to publish it on our website after assessing your fit with our team. .

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 19. Please provide us with your hourly rate, if available.

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* 20. Please disclose any potential conflicts of interest.

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* 21. Thank you for your time, interest, and commitment to transforming health systems. Please feel free to provide any additional comments.

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* 22. Please provide us with a list of organizations or associations with which you are affiliated or are a member.

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* 23. Please provide a writing sample (in Spanish and in English). You can provide a link to a publication or you can cut and paste a paragraph in the box.