In our continuing efforts to better serve the CHW community at large it is helpful for us to know who is using our work and where it is being put into play.

If you could answer these few questions we’d appreciate it.

-the envision team

Name *

First Name

Last Name

Email *

Zip Code *

Which of these best describes you? *

CHW / CHR / Promotora

CHW ally (actively supporting CHW workforce)

Other

Which of the following best describes your organization? *

State Health Dept.

Local Health Dept.

Tribal Health Dept.

Island Nation Health Dept.

Federal Govt.

Community Based Organization

Health Care Entity

Academic Institution

CHW org/association/network

Other

Comments

Which of the following best describes your role in your organization? *

Volunteer

Staff

Manager

Director

Faculty

Other

Your organization

Thank you!

We appreicate you and your input.

You can download the FST using this link.

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Contact

Address:
610 Walnut St,
Madison, WI 53726

Email:
hello@envisionequity.org

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This website is supported by the Wisconsin Department of Health, with funding received through cooperative agreement NU58DP007026, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.

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