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* 1. What are areas of concern for you or the people you care about? (Select all that apply)

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* 2. Please share any other areas of concern that you have.

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* 3. How can our Mental Health Ministry best support these concerns? (Select all that apply)

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* 4. Please share any other suggestions that you have for our Mental Health Ministry.

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* 5. I have experience/talents and additional resources that I would like to share or volunteer.

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* 6. Name

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* 7. Phone

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