Clone of THE TRIAGE ROOM™Ministerial Consultation & Services Interest Form. Assess | St

  • THE TRIAGE ROOM™

    Organizational Consultation Interest Form

    Assess | Stabilize | Treat

  • SECTION 1 – About The Triage Room™
    The Triage Room™ provides structured leadership and ministry consulting grounded in the

    Assess | Stabilize | Treat framework.

    Thank you for your interest in engaging The Triage Room™.

    We provide executive advisory, crisis stabilization, leadership development, and organizational recalibration services for Corporate, Professional, Nonprofit, and Community-based organizations.

    This form allows us to assess your needs and determine the appropriate level of engagement. All submissions are treated with professional discretion.

    Submission of this form does not create a contractual relationship but initiates consultation review.

     

    Led by:Dr. Jason D. Green, Ed.D.
    Board Certified & Licensed Christian Counselor (NACC)
    Board Certified & Licensed Chaplain
    San Diego Black Chaplains Association
    Chancellor, Man of War Ministry School of Seminary & Chaplaincy
    Recipient, Honorary Doctorate in Christian Counseling
    Ordained Apostle & Prophet

    Professional Expertise Includes:

    Crisis Intervention & Stabilization
    Trauma-Informed Leadership Systems
    Organizational Recalibration
    Executive Ministry Advisory
    Christian Counseling Frameworks
    Chaplaincy Training & Certification
    Conflict Mediation & Resolution
    Ministerial Identity & Governance Strategy

  • Format: (000) 000-0000.
  • What is the estimated size of your leadership team?*
  • Number of Employees / Staff:
  • Select Organization Type:

  • SECTION 2 – Reason for Inquiry

  • What prompted your interest in consultation with The Triage Room™?*
  • How would you describe your current leadership environment?*

  • SECTION 3 – Services of Interest

    Please indicate which services you are interested in exploring:
  • Leadership & Organizational Consulting*
  • Crisis & Stabilization Services*
  • Business Scaffolding & Structural Development *
  • Workplace Culture & Retention
  • Systems & Operational Development
  • Internal Employee Systems Support Services*
  • Systems & Operational Development

  • SECTION 4: INVESTMENT READINESS

    Have funds been allocated for consulting services?
  • Have funds been allocated for consulting services?
  • Estimated Budget Range:
  • Educational & Institutional Services*

  • SECTION 5 – Desired Outcome

  • SECTION 6 – Timeline

  • When are you seeking to begin services?*

  • SECTION 7 : CONFIDENTIALITY & INTELLECTUAL PROPERTY
    All inquiries are treated with professional discretion. Submission of this form does not create a therapeutic or legal relationship but initiates consultation review.

    Information shared will not be distributed outside The Triage Room™ without written consent, except where required by law.

    All methodologies, assessments, training modules, and frameworks of The Triage Room™ are protected intellectual property and may not be duplicated, distributed, or implemented independently without written authorization.

    Submission of this form does not constitute contractual engagement.

     

    SECTION 8 – Agreement

     

  • By submitting this form, I affirm that:*
  • Date*
     - -
  • Should be Empty: