Form 1 BYOMM After Action

OMB Control Number: 0925-0648

Expiration Date: 05/31/2021

Thank you for all your work in organizing an event to support the Brother, You’re on My Mind
(BYOMM) Initiative. Please complete the following assessment within 10 days of your event.
Omega Psi Phi Fraternity, Inc.’s international headquarters will use the information to describe the
types of activities that chapters are implementing.
Organizer Name: ________________________________
Organizer Email: ________________________________
Organizer Phone Number: ________________________
Chapter Name: _________________________________
District: _______________________________________
1. Date of event: _________________
2. Location (city, state) of community event: __________________________________
3. Type of event:
 Had a mental health professional speak during a chapter meeting to discuss depression
and/or mental health
 Displayed and distributed print materials at key locations (e.g., barbershops, churches)
 Hosted a community forum on mental health for men
 Participated in a health fair and distributed materials
 Worked with congregations and health ministries to focus on mental health
 Other (please describe)
_____________________________________________________________________
______________________________________________________________________
4. How many participants attended this BYOMM event? ______________
5. Did you work with partners to plan or implement this BYOMM event?
 Yes
 No

6. Please indicate the types of partners that supported this BYOMM event
(select all that apply).
 Community leader
 Mental health organization or professional
 Health care or social service (e.g., local health department, community health center)
 Congregation or health ministry
 School
 Other Greek letter organization
 Community-based organization
 Other (please describe)
______________________________________________
7. Did you use the BYOMM toolkit materials to plan and implement this event?
 Yes (please indicate how helpful these materials were)
 Extremely helpful
 Very helpful
 Somewhat helpful
 Slightly helpful
 Not at all helpful
 No (please describe why)
______________________________________________
8. Did you connect participants to a mental health professional and/or organization or distribute
resources on how to locate mental health resources?
 Yes
 No
9. Were there any personal stories that were shared by participants describing the impact of
the BYOMM event?
 Yes (please describe) _________________________________________________
 No
10. If you have any additional feedback about this event, please describe below