Monthly Stats: For TA/Training Monthly Stats Report Question Title * 1. Your Name: OK Question Title * 2. Name of Program TA/training provided to OK Question Title * 3. TA/training provided via...? (select as many as needed) Phone Email In-person Other (please specify) OK Question Title * 4. Date(s) of TA/training OK Question Title * 5. How many people attended and what is their role? Please list in the following format: ex.) 17 advocates; 5 hospital staff; 3 community members OK Question Title * 6. Please provide a brief description of the TA/training (i.e. topic area) OK Question Title * 7. Please list any major successes, information from evaluations, etc. OK Question Title * 8. Additional comments: OK DONE