BHSA Transition Taskforce - Interest Survey

Participant Information

Please complete this survey if you are interested in participating in an advisory role for the Proposition 1 - Behavioral Health Services Act (BHSA) Transition Taskforce. The advisory members will be made up of diverse representation from clients, family members, community and partner agencies. The Taskforce meetings will open to the public.

You must be able to commit to attending all three (4) taskforce meetings if participating in an advisory role. The meetings will be hybrid and scheduled for April 3rd, June 5th, August 7th and October 2nd from 3-4:30pm.

The following questionnaire will help us ensure there is diversity in lived experience, cultural and geographic representation and subject matter expertise.

This survey will close on Friday 2/28/25.

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* 1. Please provide your name.

First Name:

Last Name:

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* 2. Please provide your email. We will contact you to confirm your participation and provide you with meeting information.

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* 3. Are you a member of any behavioral health-related advocacy group or coalition/collaborative?

Yes. Please list all behavioral health-related groups you are affiliated with:

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* 4. Are you participating as an employee or board member of an organization/agency?

Yes. Please list the organization(s) you are representing and your title/role at each: