VAMC Adaptive Sports Survey

Move United /

VAMC Adaptive Sports Training Needs Survey 2024

Name of VA Medical Center or DOD Facility*
VAMC or DOD Facility Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Contact Name*
Title*
Email*
Phone*
Adaptive Sports Training Needs*
Check all that apply
- Hosting an adaptive sports informational expo
- Hosting an adaptive sports training at my facility
- Attending an adaptive sports training in my region
- Attending national adaptive sports trainings
- Online adaptive sports training
Please list facilities or local partners where training or expo could be hosted (if applicable)
List any relevant amenities, details and size, i.e. multi-use indoor court space (3 basketball courts) and whether on-site or off-site
Please describe adaptive sports training needs
Use this space to describe the type of training needed. Is it for your personal development or to create a new sport opportunity at your VAMC? Do you have the support of staff and leadership at your VAMC to offer sports you are interested in? Does your VAMC offer the sport already or will this be a new activity for your facility? How many Veterans have expressed interest?
Please list any related sports equipment that would be needed to support the continuation of the program after the training
For example, if we train 10 providers for air rifle, list any known equipment needs to successfully conduct an ongoing program, i.e: 4 air rifles, storage case, targets, rests, etc
Other adaptive sports needs
Please use this space to describe any other adaptive sports needs your facility may have that you wish to let Move United know about
Please attach your support letter(s) here
Move United may include your site within its 2024 adaptive sports training grant proposal. A letter of support is required for us to include your facility.
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VAMC Adaptive Sports Survey

VAMC Adaptive Sports Training Needs Survey 2024

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