Please complete the RAC needs assessment form below: Please state your organization name(Required) Please state your organization Address, including County(Required) Which domain(s) does your organization or agency most closely identify? (Check Domains that Apply)(Required) Housing Community Safety Food Access Healthcare Child Care Employment Transportation Mental Health Services Substance Use Disorder Opioids Opioids Family Support Parenting Youth Programming Sexual Health and Safety LGBTQ+ Does your organization or agency know about ACEs and trauma-informed care?(Required) Yes No Don’t Know Have you ever attended a training on Adverse Childhood Experiences?(Required) What do you remember most about the training?(Required)Do you feel anyone in your organization or community could benefit from an ACEs training and advanced opportunities with external partners?(Required)Do you currently practice trauma-informed care and prevention/intervention around ACEs?(Required)What can you highlight about your community?(Required)What are some of the current activities or initiatives you are looking to create or expand for your community?(Required)How can your community benefit from this Acenda RAC South initiative?(Required)Do you have any events planned in the future for this initiative? If so, when?(Required)What are your goals with the RAC South Initiative and why?(Required)Who is assigned to this initiative from your organization?(Required)Please provide any names, phone numbers, and email addresses that should be included in emails when discussing this initiative. (Required)Are you connected or working with an organization that you would like to partner with on the RAC South Initiative?(Required)How do you feel Acenda RAC South can support you through this process?(Required)Who is your target family/community/person for this initiative? Age Range? Location?What is the start date and end date that would be ideal for you to complete this RAC South Initiative?(Required)
