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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