To initiate a request for consultation or technical assistance, please complete and submit the form below. In order to provide high quality, responsive technical assistance, it would be helpful to give as much lead-time as possible. Please enter only one request per form.

Requests will be reviewed by the Center and sent to the NH Bureau of Drug & Alcohol Services for approval before technical assistance is provided. You will receive a response to your request within 10 business days.

Feel free to contact the Center by emailing nhcenterforexcellence@jsi.com or by calling (603) 573-3333 with any questions you may have.

Thank you for your interest in reducing alcohol and other drug misuse and promoting recovery.

 







City*

State*

Substance use focus area related to your request (press ‘ctrl’ to select more than one focus area)*

Are you currently receiving funding from the NH Bureau of Drug and Alcohol Services?*

Are you currently participating in the Regional Network in your area?*


Requested Date of Completion (MM/DD/YYYY)*