Latinx Mental Health Project Interest Form

Welcome to our Latinx Mental Health Project.

This project aims to bridge the gap between mental health access and the Latinx Community. We will offer training via webinars and talks for providers and community outreach.

If you would like to learn more please fill out this form below. We love to hear from you and about you!

For any questions please contact Camila Pulgar at capulgar@wakehealth.edu

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* 1. Name

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* 2. Organization

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* 3. Title

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* 4. Email

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* 5. What best describes the population you serve (select all that apply)

Latinx only

Latinx and non-Latinx

College Students

Children and Families

Veterans

LGBTQ+

All of the above

Not practicing at the moment

Other (please specify)

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* 6. Interests

Research and Funding: Identify opportunities and grant writing

Community Outreach: Events

Training: Webinars and Workshops

Connecting with other Latinx Providers

Evidence based interventions with Latinx clients

Other (please specify)

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* 1. Name

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* 2. Organization

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* 3. Title

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* 4. Email

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* 5. What best describes the population you serve (select all that apply)

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* 6. Interests

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* 7. Additional Comments