Thank you for your interest in Autism Speaks Global Autism Public Health Initiative (GAPH). Please fill out the following short survey and one of our Pubic Health team members will be in contact with you. Please allow some time for our response.

For more information about GAPH, please click here.

Volunteers Needed! To learn more about an exciting new Global Autism Public Health collaborative endeavor between Autism Speaks and the International Society for Autism Research (INSAR), please click here.

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* 1. Name

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* 2. Title

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* 3. Degree

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* 4. Institution

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* 5. Email Address

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* 6. Phone Number

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* 7. Area(s) of autism expertise

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* 8. Are you a clinician?

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* 9. Do you have experience as a trainer?

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* 10. Countries of interest

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* 11. Languages Spoken

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* 12. Additional Comments

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