Hurricane Response Hub Technical Assistance Request Form

Thank you for reaching out to the Hurricane Response Hub with your disaster-related morbidity and mortality surveillance, environmental health or occupational workforce needs.

Please complete this short form to request technical assistance and a Hurricane Response Hub Technical Assistance Center representative will contact you within 1 business day.








Select your state or territory from this drop down list.


Please select the TA request topic from the drop down list. If Other, please describe in the text box below.


Please tell us what type of TA you are seeking: Resources, Training, or Other. If you select other, please describe in the text box below.


Please briefly tell us more about your workforce or training technical assistance needs.


Describe the goals and outcomes you would like to achieve as a result of this TA.



Please attach anything that will help us with your request.


Please tell us how you learned about this initiative (optional).






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