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Thank you for looking to contact and/or partner with the National Association of Community Health Workers (NACHW)!
This contact form serves as the primary way to begin working with NACHW or getting a question answered! Please allow us up-to 5 business days to respond to your request. Thank you and we look forward to assisting you!
Name
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First Name
Last Name
Email
*
example@example.com
Organization Name
*
Organizational Website (n/a if not applicable)
Phone Number
-
Area Code
Phone Number
State or territory:
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Organization Type
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Please Select
Community based organization
Local or state health department
Non-profit
Health center or hospital
• CHW Network: a state/regional organization, association, or coalition with 50%+ CHW leadership & membership, whose mission/activities focus on CHW training, workforce development, mentoring, member mobilization, cross-sector networking, and advocacy
• Non-profit community-based organization (CBO) that offers culturally-centered/specific services Other non-profit
• Local or state health department
• Other governmental department, agency, organization
• Education Service District or school (grades K-12)
• College or university
• Clinic or hospital or other organization where licensed medical professionals provide health services
• Federally Qualified Health Center (FQHC) Rural Health Clinic (RHC)
• Health insurance/payer, health plan, and/or payer-provider organization Consulting company or technical assistance provider Unemployed/looking for work
• Tribal organization
• Other:
What is the scope of this organization's services or activities?
*
Local
Statewide
Regional
National
International
Unsure
How did you hear about NACHW? (Please check all that apply)
NACHW’s social media
NACHW’s website
A NACHW webinar or event
I saw NACHW present at someone else’s event.
A friend or co-worker
My employer
My local or state CHW Network (Association or Coalition)
National or Local News Media or Publications
Other
Community Health Workers (CHWs) is an umbrella term including Promotor/a de Salud, Community Health Representative (CHR), tribal (CHW)
I am a
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CHW
Ally
Type of membership
Individual Member
Not a member
I am part of Organizational member
I am part of the Network Member
I am a member at another network/association
Please explain how we can assist or partner:
Submit
Should be Empty: