Local evaluation issues

  data management (MIS) and/or data collection
  survey instrument development and measurement issues
  model development and articulation
  data analysis and presentation of findings
  other evaluation issue

Service delivery issues

   outreach related
   case management and advocacy
   primary care
   other service delivery issue

Administrative

   assistance with IRB (protection of human subjects)
   grant writing and grant administration
   other grant administrative issue

Please provide a brief description of technical assistance need:

Preferred method for technical assistance
  e-mail           phone           face-to-face (site visit)

Name 

Agency

Phone 

E-mail