OPRAH Service Request

Organization Name*

Contact Name*

First Last

Position*

Executive Director
Board Chair / President

Phone*

Email*

LHIN*

Are you an OAN Member or Affiliate?*

Member
Affiliate

Does your agency have a Union?*

Yes
No

City*

Issue urgency*

Urgent/expedite (same day)
Time sensitive (within 2 business days)

Issue summary*

OPRAH and OODP

From time to time, the OAN OPRAH program and the Ontario Organizational Development Program (OODP) are working with the same organization to address a similar or complimentary issue. In these situations, it would be beneficial for both programs (OPRAH and OODP) to share relevant information about the issue to enable the programs to better support and serve the organization.

Is your organization using support from the OODP?*

Currently
In the past six months
In the next six months
None of the Above

Do you authorize the OPRAH program and the OODP to share information about your organization that is relevant to this consult?*

Yes
No

Please explain the focus of the work with OODP*

Please note that this information is collected to help coordinate and schedule your request and to avoid duplication of services. Do not disclose confidential information here.