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True You Maryland: Positive Prevention PLUS Adaptation Request Form

Contact Information

Thank you for submitting an adaptation request. Please provide comprehensive information and rationale for the adaptation you anticipate needing.  Contact Deborah Chilcoat at deborah@healthyteennetwork.org if you have questions about your adaptation request.
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4. Which of the following best describes you? *This question is required.
5. Who will be implementing the proposed adaptation(s)? *This question is required.