Name *

First Name

Last Name

Roles

Youth or Family Member accessing services

Community Advocate (ex. NAMI member)

Government Stakeholder or Policy Maker

Clinician/Social Worker/Peer Specialist/etc.

Researcher/Research Assistant

Other

Do you live, work, or receive mental health services in the state of Massachusetts *

Yes

No

Are you interested in receiving Continuing Education Credits for this event? *

Please note that you must register & pay for CEs separately in addition to your conference registration. If checked, you will receive a CE registration link at the email provided here ahead of the conference.

Yes

No

Do you plan to attend Day 1 of the conference (October 21) in-person at Bentley University? *

Please note that Day 2 of the conference (October 22) will be hosted completely virtually.

Yes

No

Maybe