Service Request Form

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Please complete the below information and one of our staff will contact you via phone or email soon. If you have any questions while completing the Request Form, or prefer to speak to someone directly, please contact us at 605-688-4299.

Thank you for your interest in the Population Health Evaluation Center!

Personal and Contact Information

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Services

Types of services requesting (select all that apply):

Program Evaluation

Research and Evaluation Design Consultation

Survey Design and Administration (mail, phone, internet)

Focus Groups and Interview Facilitation

Mapping

Data Visualizations

Needs Assessments

Qualitative and Quantitative Analysis

Technical and Brief Reports

Instrument Identification

Database Development and Data Management

Policy Assessment

Program Monitoring

Logic Models and Evaluation Plans

Performance Measurement Plans

Presentations and Publications (at the request of clients)

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