Request technical assistance from the Center of Excellence
Location (State/Territory/Tribe/County/City as app
Is your program part of a federal grant program?
Indigenous Project LAUNCH (SAMHSA)
Project LAUNCH (SAMHSA)
Tribal MIECHV (ACF)
Head Start (ACF)
System of Care for Children's Mental Health (SAMHSA)
If other, name of other federal grant program(s)
What is the area you are most interested in for technical assistance? Examples are intended only to help explain the areas; your technical assistance request may vary!
Programs & Models
Policy & Financing
Research & Evaluation
On a scale of 1-5, where are you in the process of developing and implementing an evidence based IECMHC model?
1: Just starting on our journey
3: Implementing a program and do not yet have systematic data collection in place
5: We have completed a randomized control trial
TA Request Timeline
In 4-6 weeks
In 2 months or longer
Are you requesting TA specifically related to IECMHC during the COVID-19 pandemic?
(check box if yes, leave blank if no)
If yes, please provide more details in the text box below
By participating in technical assistance, I am agreeing to the following terms:
-I understand that Technical Assistance is provided through funding from SAMHSA. To support compliance with funding requirements, I may be asked to complete one or more brief evaluation surveys about my experiences with Technical Assistance. I agree that I will complete these surveys in a timely manner.
-I understand that my contact information and program name may be shared with the Center of Excellence’s partners and Consultation Council for the purpose of coordinating across related systems and ensuring that my program receives high-quality services and resources. More information on the Center of Excellence’s partners can be found here:
Please attach anything that will help us with your request.
Send me a copy of my responses
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