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Behavioral Health Collaborative
Please complete this form to help VAN identify your interests and willingness to engage in the Washington County Behavioral Health Collaborative
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Name
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Your answer
Preferred email
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Your answer
Organization (if any)
Your answer
What is your PRIMARY focus area of interest?
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Workforce training
Immediate care
Child care
Awareness campaign
With this primary focus area in mind, what role is the "best" (most appropriate) for you to play? (NO commitment is being asked of you at this time)
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1- Lead (responsible for planning, coordinating partners/stakeholders to achieve outcomes)
2- Key partner (plays critical role in working towards desired outcomes)
3- Supportive stakeholder (lends support to focus area through feedback, promotion, etc.)
What ADDITIONAL focus areas are you willing to support? (Check ALL that apply)
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Workforce training
Immediate care
Child care
Awareness campaign
None at this time
Required
What role are you willing to consider for these additional focus areas? (NO commitment is required at this time; Check ALL that apply)
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1- Lead (responsible for planning, coordinating partners/stakeholders to achieve outcomes)
2- Key partner (plays critical role in working towards desired outcomes)
3- Supportive stakeholder (lends support to focus area through feedback, promotion, etc.)
4- Not applicable
Required
Add any comments that will help VAN understand your willingness and ability to engage in this initiative. Thanks!
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