Organizational Development Request for Services

Organizational Development Request for Services

NOTE: Due to the high volume of requests, we require 30-60 days’ notice to arrange and prepare for a retreat/workshop. All requests will be considered on a case-by-case basis. All efforts will be made to accommodate your request.

For support from the UVA Learning and Development department, please use the intake form here:

Learning and Development Request Form

Today's date:

Please tell us more about you.

Name:*

Email:*

Computing ID (e.g. MTO3U):*

Phone number (XXX-XXX-XXXX):*

Job title/position:*

Department:*

Who is your HR Business Partner?*

Is your HRBP aware of the topic of this request?*

(Yes/No)

Please tell us more about your need.

Please select the area of perceived need from the lists below. All work will include collaboration with department/school/unit leadership to determine the best approach, design and/or solution.

For support from the UVA Learning and Development department, please use the intake form here:

Learning and Development Request Form

Organizational Development Services*

Please select all that apply.

Select or enter value

Unsure?

Please check the box to talk with a consultant about narrowing the focus.

Situation / Background:*

Please provide a brief, relevant history and explanation of the problem you are trying to solve. If applicable, include specific behaviors that need to start, stop or continue.

Actions Already Undertaken*

We recommend leaders take concrete steps in advance toward their own personal growth and development to address team issues. To date, what attempts have been made to address the need? What was the result of those efforts? What trainings have you attended, what consulting/coaching have you obtained?

Desired Outcomes:*

What outcomes are you hoping to achieve as a result of this work? How will you know if you are successful on the backend of this initiative? (i.e. are there specific behavioral behaviors you would like to see, or metrics that show success?)

Additional Information:*

Please include any additional information that you would like us to know before getting started. Ex: Are there any time constraints? Do you prefer a virtual or in-person engagement?

Agreement

Initial attestation:

I and/or my area leader agree to be involved and supportive of this work to help assure that we successfully achieve the desired goals and sustain the positive change/improvement sought through this effort.

Fees*

I understand that there may be fees, if applicable, for: - External vendors - Formal materials or assessments (e.g., 360 assessments) Any relevant fees will be explained and agreed to in advance.

E-signature: (Please initial below)*

Send me a copy of my responses

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