Register

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Please provide the information below so that we can create your Go NAPSACC account.

TECHNICAL ASSISTANT PROVIDER INFORMATION


ORGANIZATION INFORMATION

Please note: This email address will be your Go NAPSACC User Name and the way we contact you.
Please specify if not listed
Please indicate the counties you serve by selecting on the left and using the arrows to move to the right. If you serve all counties in your area please select All.

USER INFORMATION

This will be your user name
Minimum 8 characters
Enter the code that you were provided here. If you do not have a code, please contact us.

TERMS AND CONDITIONS

After completing registration on the Go NAPSACC website, Go NAPSACC staff will be able to see your contact information and any other information you provide (including, but not limited to, your Consultant notes). Go NAPSACC staff may use this information in publications and presentations, or to make improvements to the website. You will not be personally identified in any public presentations or publications. However, Go NAPSACC staff may share your data with designated state agencies and other partners in order to track overall use of the website, facilitate technical assistance for registered Go NAPSACC users, and assess the impact of Go NAPSACC. Go NAPSACC Consultant users understand that they will have access to provider information and Go NAPSACC activity. Consultant users agree that they will only use this information in an appropriate professional capacity, and will not share it with unauthorized third parties for commercial or other purposes not related to the provision of technical assistance. By clicking this box, you understand and agree to this use of your Go NAPSACC account and data.

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Required for registration

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