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* 1. Organization Name

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* 2. Organization type

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* 3. Your Name

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* 4. Title

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* 5. Email Address

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* 6. Community/communities served

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* 7. Can we contact you about this survey?

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* 8. How familiar are you with Occupational Therapy?

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* 9. Are you familiar with the scope of interventions Occupational Therapy can provide?

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* 10. Is whole health prioritized in your organization?

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* 11. What barriers do you face in integrating whole health into the everyday life of those you serve?

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* 12. Do you currently have open positions for occupational therapists?

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* 13. What unmet needs are there in your organization related to Occupational Therapy?

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* 14. What unmet needs are there in your organization related to Mental Health?

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* 15. What unmet needs are there in your organization related to overall health and wellness?

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* 16. How does funding affect your employment of Occupational Therapy professionals?

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* 17. What are your primary funding sources?

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* 18. Do you have established working relationships or partnerships with organizations in your community centered on community integration?

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* 19. What are your goals to increase and strengthen community partnerships?

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* 20. Would you be interested in the opportunity to resource share an Occupational Therapy professional in your community if available?

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* 21. Other comments or feedback

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