• HAVI Training & Technical Assistance Request Form

  • Thank you for reaching out for information about The HAVI's training and/or techncial assistance. Please complete the form as completely as possible.

    If you are requesting the HAVI as a speaker for an event, please complete the HAVI Contact form.

  • Type of Organization*
  • Format: (000) 000-0000.
  • Have you previously been in contact with anyone at the HAVI?*
  • Is there a Hospital-Based Violence Intervention Program (HVIP) located within 50 miles of where you are planning to start your program?*
  • Are you proposing to work within the same hospital as the current program within that city?*
  • Have you been in contact with the current organization working within the hospital?*
  • Are you completing this form on behalf of someone else?*
  • Format: (000) 000-0000.
  • What Training or Technical Assistance are you interested in pursuing at this time?*
  • Would you like to schedule a meeting with the HAVI at this time to answer any general questions?*
  • Do you currently have a HVIP?*
  • Are you a current HAVI member?*
  • What type of program is your HVIP?*
  • Are you currently seeing clients?*
  • Are you hoping to start a HVIP within the next year?*
  • Do you currently have funding for training and technical assistance?*

  • Violence Prevention Professional (VPP) Certification training is the Health Alliance for Violence Intervention’s national training program for frontline violence intervention workers. For more information on training, please visit our website www.thehavi.org.

  • Are you interested in receiving VPP training for yourself or frontline violence intervention workers at your program?
  • Are you interested in receiving more information about trainings and webinars?*
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  • Would you like to be added to the HAVI newsletter to receive regular updates from the HAVI?*
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  • When you click submit, your information will be shared with our Business Development team. We make every effort to respond via email in three to five business days. Thank you for your inquiry.

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