Thank you for your interest in these initiatives!

Due to the volume of inquiries that we receive regarding Becoming a Mom® and other Kansas Perinatal Community Collaborative initiatives, we have created a quick survey for interested communities to complete as the first step in your onboarding process. The survey takes about 3 minutes to complete, and covers basic information about your community and its perinatal resources. Please feel free to elaborate when needed in the “other” text boxes provided! The information gathered from the survey will help us get to know your community and where you are in your planning process. It will also allow us to provide you with customized technical assistance based on your implementation plans and initiatives of interest.

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* 1. Please tell us about yourself

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* 2. Which community-wide coalitions are currently in place?