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HES Advantage Inquiry Form
Step
1
of
4
25%
Name
(Required)
First
Last
Pronouns
Name of Organization (if applicable)
Phone
(Required)
Email
(Required)
Dates and timeframe for training to occur
(Required)
Please describe specific day of the week, month, timeframe, etc.
Training timeframe
(Required)
1.5 hours
2 hours
Half-day workshop - 4 hours
Multi-workshop offerings
Who will be attending the training?
(Required)
Staff
Community members
Elected officials
please describe the Staff levels, ex., Board, c-level suite, direct care, etc.
Does this group meet regularly?
Yes
No
Would you like to be an in-person or virtual training?
in-person
Virtual
Where would this occur?
How many people are you hoping to accommodate?
Accessibility – is there any accommodation needed, if so, please share.
Language - do you require translation services during the training?
Yes
No
please share what language
Do all staff have access to a webcam & microphone (our training(s) are highly participatory based)
Yes
No
How many people are you hoping to accommodate?
Please enter a number from
1
to
999
.
Accessibility – is there any accommodation needed?
Yes
No
Please share your accessibility accommodation needs
Language- do you require translation services during the training?
Yes
No
Please share what language
Do you have a specific training you are interested in?
None
Health Equity - The Basics
Cultural Humility
Implicit Bias
JEDI (An Introductory Conversation Justice, Equity, Diversity, & Inclusion)
Trauma-Informed & Identity-Conscious Care
Accessible Healthcare for Undocumented Immigrants
Racism, Anti-Racism, and Racial Equity in Healthcare
Social Determinants of Health
Advocacy 101 & 102
Asset-Based Community Development
Storytelling for Advocacy
Custom
A list of our trainings can be found on
the HES Advantage page here
.
Please give a summary of your custom training interest here
What are some of the goals and outcomes you are hoping to meet from this training?
What is your total organization size?
What is your organizational operation budget range?
Specific budget range for desired training(s)?
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