TA Intake Form

NHTAC@growthpartners.llc

TA Intake Form

TA Intake Form

Are you ready to take the next step?
Fill out the Technical Assistance Request Form Below:

Please complete the form, providing as much detail as possible on the work you are doing and the support you seek. (All fields are required.) All TA requests require approval by BDAS before initiation of work.

"*" indicates required fields

Name*
Are you currently receiving funding from the NH Bureau of Drug and Alcohol Services?*
This field is for validation purposes and should be left unchanged.