Agency Survey
This survey will be used to determine what issues our community currently faces, what the community needs are, and what resources are available. Estimated time: 20 minutes
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Email *
Name of your organization? *
What are the top three issues you see in our community? *
What programs are currently offered by your organization? *
How does your organization reach/serve at risk populations? (Some examples include someone who is homeless, speaks a language different from your own, in a situation involving domestic violence, etc.) *
Are there any evidence-based health promotion-specific programs in place currently? (Examples may be UT Extension Nutrition programs, Triple P Parenting, Michigan Model, SAMHSA curricula etc.) *
What needs do you see most often in your clients? (Some examples may be: Food, Shelter, Education, Childcare, Housing, Work, Lack of secure medication storage, access to naloxone, access to mental health/medical/dental services, transportation, etc.) *
How do your clients find your services? Through referrals? Community outreach? *
Does this organization refer clients to other services in the community? Please share about the ease or struggle of organizations working together in your community for the best of the client. *
What other organizations or services do you know of in the area that are working to meet community needs? *
What programs are needed for your clients that you do not offer or cannot find in your community? *
What are the most pressing needs of the community in terms of reducing and preventing substance (alcohol, tobacco, and drug) use? *
Where in the community do your clients like to hang out or spend leisure time? *
Where, in the community are your programs offered? (Ex: downtown Elizabethton, Happy Valley area, Stoney Creek area, Hampton, Roan Mountain, etc.) *
Are there specific geographical locations in your community that you struggle to reach? If yes, would a virtual format assist you to provide education in those areas? *
How is your organization currently adapting to technology needs? Is your organization currently adapting to use technology due to COVID regulations? If yes, how? *
What barriers do you or your organization face with using technology? *
Does your organization currently use or have any type of online learning or training center? If so, what, and how often? *
If an online learning program, such as a Learning Management System, was created as a tool for anyone in the community to access, would your organization use it and what should it include? *
If an online learning center becomes available, would this be something you’d be willing to pay to use for clients? Pay to use to train staff?   *
Would you be willing to record or otherwise contribute programs you offer to a virtual training center? *
Email or name of person filling out this survey (so we can follow up with you if needed)
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