Request Individualized Technical Assistance

Individualized Technical Assistance Form

Fill out and submit this form to request individualized technical assistance from the ITACC staff and/or subject matter experienced people from the DD Council Network.

Today’s date:(Required)

Name of person making the request:(Required)

First Last

Email Address:(Required)

Where is your Council located?(Required)

Enter your state / territory name

Type of Request(Required)

Please select one.

Individualized TA (one-on-one, intensive assistance)

Subject Matter Expert (access to someone in the network with subject matter experience, knowledge, and skills)

Is the situation you are facing:(Required)

Please select one.

New to T/TA.

Follow-up on a prior T/TA request.

T/TA for an ongoing issue.

Request:(Required)

What is your expected outcome from receiving T/TA?(Required)

CAPTCHA

This field is for validation purposes and should be left unchanged.