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* 1. What agency do you work at and what is your role?

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* 2. Are you a member of  Illinois Association of Infant Mental Health(ILAIMH)?

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* 3. How long have you been in the field of infant/childhood mental health?

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* 4. What population do you serve?

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* 5. Would reflective case consultation benefit your work?

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* 6. Please check the following professional development topics that intrest you.

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* 7. I'd like more information about the Association and local chapters.

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