You can always press Enter⏎ to continue
Diversity, Equity, & Inclusion Taskforce
Hello AMHCA Members, Please share your continuous feedback (July 1, 2020 to June 30, 2021). Your comments are valuable as we grow together. Thanks, Dr. Beverly Smith, President-Elect
START
1
Please share your feedback in regards to Diversity, Equity, & Inclusion as it pertains to the intersectionality of Mental Healthcare.
*
This field is required.
(As it relates to AMCHA, share any special considerations, suggestions, concerns, future panelists, future topics to cover with membership/community/stakeholders, special training for members and/or the community at-large, feedback, etc)
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
2
Share a recommended resolve and/or path for restorative practices to any concerns or feedback expressed.
(Provide a resolution that you feel would be appropriate.)
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
3
Name
*
This field is required.
Last Name, First Name
Previous
Next
Submit
Press
Enter
4
Email
*
This field is required.
example@example.com
Previous
Next
Submit
Press
Enter
5
Phone
*
This field is required.
Previous
Next
Submit
Press
Enter
6
Region
*
This field is required.
Previous
Next
Submit
Press
Enter
Should be Empty:
Diversity, Equity & Inclusion Taskforce Continuously Feedback Form
[Edit]
Question Label
1
of
6
See All
Go Back
Submit
