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Thank you for your interest in Provide’s asynchronous training! Please fill out the information below to get registered for our learning community.
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Acknowledgement Statement
By clicking here, you consent to Provide sharing your contact information with MDPH for future training opportunities, updates, and communication related to the Colleges and Universities Abortion Program (CUAP). CUAP is a program under the Sexual and Reproductive Health Program at MDPH. For more information, you can contact SRHP@mass.gov.
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How would you describe your current role? (Select all that apply.)
I work directly with clients/patients
Administration or support
Physician or physician’s assistant
Leadership (supervisor, director, executive, etc.)
Social worker
Nurse (RN, LPN, NP, midwife, etc,)
Mental or behavioral health clinician
Case worker or case manager
Client educator/advocate
Educator/education-affiliated (university, college, K-12, etc.)
Public health professional
Student
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Organization
Is the organization for which you primarily work located in a rural area?
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Don't Know
Do you work in any of the following systems of care? (Select all that apply.)
Abortion fund or practical support
Education (university, college, K-12, or other education affiliated)
Family planning
Health care – general
HIV
Intimate partner violence/domestic violence
Sexual assault
Mental and/or behavioral health
Native American/Tribal
Public health
Substance use
Title X
Other system
N/A – I am not employed or am currently a student
How would you describe your client population? (Select all that apply.)
At least half people who can get pregnant
Mostly lower income
At least half BIPOC (Black, Indigenous, and People of Color)
At least 10% LGBQ (lesbian, gay, bisexual, queer, or questioning)
At least 5% transgender, non-binary, or gender expansive
At least 20% non-native English speaking
What percentage of your clients live in a rural area?
Less than 25%
25%-50%
More than 50%
Don’t know
Occasionally, we have opportunities to participate in follow-up surveys or interviews, sometimes with incentives. May we contact you to follow up about these opportunities in the future?
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No
The following demographic questions are for the purposes of advancing Provide’s commitment to equity and to understand who we are serving so we can continue to make programs more accessible.
How would you describe your gender? (Select all that apply.)
Woman
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Non-binary
Gender non-conforming
Another gender not listed
How would you describe your race and ethnicity? (Select all that apply.)
African American, Black, or African Diaspora
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White or Caucasian
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Middle Eastern or North African
Another race or ethnicity not listed
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How did you hear about Provide’s learning community?
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