Community Request to BMHS

Jewish Family Service’s behavioral and mental health service team professionals are available to provide content specific presentations or training on a range of various topics relating to mental health and behavior.
In addition we are available to be present at programs/events that are sensitive in nature that may generate emotional responses by the audience.
We will do our best to accommodate your request. In order for Jewish Family Service BMHS team to provide you with the most appropriately credentialed professional for your request, please complete this form and submit it at least two weeks prior to the date of the program/event. Please note, submission of this form does not indicate confirmation. Our team members will be in contact you within a week of submitting this request form. Thank you!

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* 1. Organization Name

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* 2. Program Contact Person 

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* 3. Contact person phone number

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* 4. Contact person email

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* 5. Program/Event name

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* 6. Program/Event date

Date

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* 7. Program/Event Time and duration

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* 8. Program/Event Location

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* 9. Program/Event content

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* 10. Audience age group

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* 11. Audience size

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* 12. Expected outcomes from having BMHS professionals

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* 13. The suggested reimbursement for a typical 60-90 minute presentation is $250.00  We will be in contact with you to determine the cost based on audience size and your program budget

How much can your organization pay for this session? 


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* 14. What else would you like us to know? 

Thank you!

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