Sustainability Survey

Today's date:
Community:
State:

I. Demographic Information

1. What agency/organization do you represent?
Public mental health agency Private organization representing mental health
Public health agency Private organization representing health
Public child welfare agency Private organization representing child welfare
Public education Private organization representing education
Public juvenile justice agency Private organization representing juvenile justice
Family organization
2. Which of the following best describes your current position?
CMHS grant community project director Agency/organization director or manager
Agency/organization staff member Family organization member
Family member, not affiliated with an organization Other (please specify):

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