{"id":3043,"date":"2020-06-02T13:53:04","date_gmt":"2020-06-02T17:53:04","guid":{"rendered":"https:\/\/health.uconn.edu\/health-disparities\/?page_id=3043"},"modified":"2020-06-02T13:53:04","modified_gmt":"2020-06-02T17:53:04","slug":"contacthdi","status":"publish","type":"page","link":"https:\/\/health.uconn.edu\/health-disparities\/contacthdi\/","title":{"rendered":"Contact Us"},"content":{"rendered":"<div id=\"pl-3043\"  class=\"panel-layout\" ><div id=\"pg-3043-0\"  class=\"panel-grid panel-no-style\" ><div id=\"pgc-3043-0-0\"  class=\"panel-grid-cell\" ><div id=\"panel-3043-0-0-0\" class=\"so-panel widget widget_gform_widget gform_widget panel-first-child panel-last-child\" data-index=\"0\" ><script type=\"text\/javascript\">var 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data-js-reload=\"field_23_22\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Type of Organization<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_23_22'><li class='gchoice gchoice_23_22_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.1' type='checkbox'  value='Academic'  id='choice_23_22_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_22_1' id='label_23_22_1' class='gform-field-label gform-field-label--type-inline'>Academic<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_22_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.2' type='checkbox'  value='Service Nonprofit'  id='choice_23_22_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_22_2' id='label_23_22_2' class='gform-field-label gform-field-label--type-inline'>Service Nonprofit<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_22_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.3' type='checkbox'  value='Research Nonprofit'  id='choice_23_22_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_22_3' id='label_23_22_3' class='gform-field-label gform-field-label--type-inline'>Research Nonprofit<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_22_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.4' type='checkbox'  value='State Agency'  id='choice_23_22_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_22_4' id='label_23_22_4' class='gform-field-label gform-field-label--type-inline'>State Agency<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_22_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.5' type='checkbox'  value='Community Based Organization'  id='choice_23_22_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_22_5' id='label_23_22_5' class='gform-field-label gform-field-label--type-inline'>Community Based Organization<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_22_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.6' type='checkbox'  value='Federal Agency'  id='choice_23_22_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_22_6' id='label_23_22_6' class='gform-field-label gform-field-label--type-inline'>Federal Agency<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_22_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.7' type='checkbox'  value='Independent Contractor'  id='choice_23_22_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_22_7' id='label_23_22_7' class='gform-field-label gform-field-label--type-inline'>Independent Contractor<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_22_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.8' type='checkbox'  value='Coalition\/BMOC Alliance'  id='choice_23_22_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_22_8' id='label_23_22_8' class='gform-field-label gform-field-label--type-inline'>Coalition\/BMOC Alliance<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_22_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.9' type='checkbox'  value='Student'  id='choice_23_22_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_22_9' id='label_23_22_9' class='gform-field-label gform-field-label--type-inline'>Student<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_22_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_22.11' type='checkbox'  value='Other'  id='choice_23_22_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_22_11' id='label_23_22_11' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_23_23\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_23_23\" ><label class='gfield_label gform-field-label' for='input_23_23'>If not listed, please write in:<\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_23_23' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_23_19\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_23_19\" ><label class='gfield_label gform-field-label' for='input_23_19'>Social media handle (Twitter, Facebook, Instagram etc.)<\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_23_19' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_23_8\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_23_8\" ><label class='gfield_label gform-field-label' for='input_23_8'>Department<\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_23_8' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_23_9\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_23_9\" ><label class='gfield_label gform-field-label' for='input_23_9'>Position<\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_23_9' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_23_11\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_23_11\" ><label class='gfield_label gform-field-label' for='input_23_11'>Services Offered<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_11' id='input_23_11' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_23_13\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_23_13\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Describe your inquiry, request, or collaboration type<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_23_13'><li class='gchoice gchoice_23_13_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.1' type='checkbox'  value='Policy and Advocacy'  id='choice_23_13_1'   aria-describedby=\"gfield_description_23_13\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_23_13_1' id='label_23_13_1' class='gform-field-label gform-field-label--type-inline'>Policy and Advocacy<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_13_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.2' type='checkbox'  value='Community Outreach and Engagement'  id='choice_23_13_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_13_2' id='label_23_13_2' class='gform-field-label gform-field-label--type-inline'>Community Outreach and Engagement<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_13_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.3' type='checkbox'  value='Program\/ project development'  id='choice_23_13_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_13_3' id='label_23_13_3' class='gform-field-label gform-field-label--type-inline'>Program\/ project development<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_13_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.4' type='checkbox'  value='Data Analysis and Study Design'  id='choice_23_13_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_13_4' id='label_23_13_4' class='gform-field-label gform-field-label--type-inline'>Data Analysis and Study Design<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_13_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.5' type='checkbox'  value='Translation services'  id='choice_23_13_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_13_5' id='label_23_13_5' class='gform-field-label gform-field-label--type-inline'>Translation services<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_13_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.6' type='checkbox'  value='Internship\/ experience opportunities'  id='choice_23_13_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_13_6' id='label_23_13_6' class='gform-field-label gform-field-label--type-inline'>Internship\/ experience opportunities<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_13_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.7' type='checkbox'  value='Independent Contractor'  id='choice_23_13_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_13_7' id='label_23_13_7' class='gform-field-label gform-field-label--type-inline'>Independent Contractor<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_13_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.8' type='checkbox'  value='PolicyMap'  id='choice_23_13_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_13_8' id='label_23_13_8' class='gform-field-label gform-field-label--type-inline'>PolicyMap<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_13_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.9' type='checkbox'  value='Grant development'  id='choice_23_13_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_13_9' id='label_23_13_9' class='gform-field-label gform-field-label--type-inline'>Grant development<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_23_13_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_13.11' type='checkbox'  value='Other'  id='choice_23_13_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_23_13_11' id='label_23_13_11' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_23_13'>\n\n\n\n\n\n\n\n<\/div><\/li><li id=\"field_23_10\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_23_10\" ><label class='gfield_label gform-field-label' for='input_23_10'>If not specified, please write in<\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_23_10' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_23_16\" class=\"gfield gfield--type-checkbox gfield--type-choice 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