Help Shape Findhelp’s Behavioral Health Network

1.Organization Name(Required.)
2.Primary Contact Name(Required.)
3.Role/title(Required.)
4.Email address(Required.)
5.Which best describes your organization?(Required.)
6.Roughly how many behavioral health referrals does your organization handle per month?(Required.)
7.Primary Behavioral Health use cases (select all that apply):(Required.)
8.Do you currently maintain a Behavioral Health provider list or directory?(Required.)
9.Do you have at least one navigator or team that could participate in workflow testing?(Required.)
10.Are you able to participate in two structured feedback sessions per month during the program?(Required.)
11.How would you be interested in participating in this research? (Select all that apply)(Required.)
12.Are you open to participating in at least one of the following? (optional but encouraged)(Required.)
13.What are you hoping to improve most with this program? (select up to 3)(Required.)
14.Briefly describe your current biggest challenge with behavioral health placement.(Required.)
15.We will begin in early April, with opportunities to review designs and make recommendations on workflows. Would your users be ready to engage with the Findhelp team as early as April?(Required.)
16.This is a limited access program with defined scope and MVP access. Do you understand this is a collaborative program with structured feedback requirements?(Required.)