Impact of Georgia's Budget Cuts on Mental Health Services

Please let us know the impact that you or a loved one has experienced or that you anticipate to experience due to the state budget cuts to behavioral healthcare. 

Aggregate results will be shared with legislators, however no identifying information will be disclosed without your permission.

Please note - one survey represents one individual impacted by cuts. Please submit one response on behalf of each individual impacted.

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* 1. Contact information

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* 2. What county do you, or the person who is impacted by the budget cuts, reside?

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* 3. Have you or a loved one been directly impacted by budget cuts to behavioral health services? 

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* 4. If you are submitting this survey on behalf of a loved one, please submit the following information about the person who is directly impacted by the budget cuts.

If submitting this form for yourself, please skip this question.

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* 5. Nature of the impact

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* 6. When did these changes to services first go into effect?

Date

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* 7. Area of Impact

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* 8. Explain Impact

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* 9. What agency used to provide these funds or services?

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* 10. What services were you or your loved one receiving prior to the state budget cuts?

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* 11. Please select all that apply.

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* 12. May we contact you to speak to your legislator?

0 of 12 answered
 

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