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About You

First Name:

Last Name:

Title:

Organization:

Email:

Phone Number:

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Please explain your TA request:
Which NPMs/SMs are you focused on? What other areas you might want TA in (e.g., measurement issues related to common issues like health communication, involving community members, involving stakeholders, equity)? Are you interested in talking about your ESMs? Would you like to talk about how to plan for measures to address your needs (e.g., Root-Cause Analysis, Results-Based Accountability)?

Understanding the Decision-Making Process in TA

We employ a personalized, evidence-based TA approach that meets you where you and your organization are. To help us understand the background of your request, please anser the following question. Please answer as fully as possible; answering these questions are the first part of the TA experience – understanding the decision-making process.

Readiness for TA:
Why are you asking for this TA?  What is motivating you? What have you already done to address the issue?

Description of TA Goal(s):
What do you want to achieve? What is the outcome you want to measure?  Think about the type of TA that you will need to affect the desired outcomes.

Ultimate TA Goal(s):
Thinking about your goal(s) broadly, what broad category(ies) do you think they fit under?

Information Transfer
Capacity Building
Knowledge Increase
Change Facilitation
Behavior/Systems Change
Shared Learning

Desired TA Impact:
What would you like to see as outcomes from the TA? Remember that impact may not be immediately apparent, but we will work to ensure that the content and intensity of TA will align with your needs and desired impact.

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