Effusion Creative Solutions Admin
AZ StandDown Service Provider Survey
As service providers, please use this form to provide feedback from the StandDown event. This form will be used to provide an event summary report.
Which community's StandDown are you reporting on?
Email of person completing this form
Name of Service Provider Organization
Services your Organization provided at the StandDown Event:
Motor Vehicle Services
DES: food stamps, child support, employment assistance
Behavioral Health Services
Other: please define in next section
If you selected other in above question, please define services provided:
Number of Veterans that received services your Organization provided:
How many Veterans received referrals or follow -up for services provided over the StanDown Event
Please list services and provide total number along with a summary of your area
As a service provider, what feedback would you care to share with the event organizers for next year?
Do Not Fill This Out