Perinatal and Infant Mental Health PSA Dissemination
Thank you for answering these brief questions to help us keep track of where the PSA is shared and how we can best reach all families and providers across TN!
-Diana and Keena, AIMHiTN and PSI-TN
morelen@etsu.edu and keenafg@aimhitn.org
Sign in to Google to save your progress. Learn more
Your role/agency
Please list the ways that you have shared or plan to share the PSA.

Please list:
-Audience (who did you share it with?)
-Sectors/roles (e.g., childcare providers, families in home-visiting, staff)
-Method of sharing (e.g., presented in a meeting, emailed listserv, shared with a client in session)
Potential number of people  that you reached (e.g., if you shared on a listserv, how many people are on that listserv). Please type a number (e.g., 2, 15, 100) rather than words (aka: don't type out two, fifteen)
Of the folks that you were able to share with, how many are members of any of the below groups/identities (check as many as apply)
Of the folks that you were able to share with, how many are members of (or specifically serve clients who are members of) any of the below groups/identities (check as many as apply)
What suggestions do you have for us about how we can best reach as many providers and families as possible?
Is there any other feedback you would like to offer about the PSA, the dissemination tool kit, or our work to share this across TN?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms