Provider Needs Assessment Survey

The WV IMPACT project is working with communities to create opportunities and address the needs of children diagnosed with Neonatal Abstinence Syndrome (NAS) or exposed to substances in utero. 

This short survey will help us better understand service providers’ issues and areas of need in regard to mothers who are using or have used substances to develop resources for service providers. Responses will be used to inform training and technical assistance content, to target technical assistance to the most important audiences, to establish a baseline for measuring future changes associated with IMPACT and identify further resources needed. 

Your participation in this project will take approximately 10 minutes to complete.

Your involvement in this project will be kept as confidential as legally possible. All data will be reported in the aggregate. You will not be asked any questions that could lead back to your identity as a participant. Your participation is completely voluntary. You may skip any question that you do not wish to answer and you may discontinue at any time. 

If you have any questions, please feel free to contact me at 304-293-2914 or by e-mail at

I hope that you will take a few minutes to share your experiences, as it could help us better understand participation and needs within the WV IMPACT program, burnout, secondary trauma, and resilience. Thank you for your time and consideration.
Lesley Cottrell, Ph. D., Principal Investigator
Professor of Pediatrics
Director, WVU Center for Excellence in Disabilities

West Virginia University’s Institutional Review Board acknowledgment of this project is on file.