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TMHRC Feedback Form

Thank you for visiting WRCAC's Telemental Health Resource Center (TMHRC)! You can use this form to:

Submit a resource to be considered for the TMHRC
Provide general feedback on how we can improve the TMHRC

If you have any questions about this form, please email slo@rchsd.org.

1. What would you like to do today? Select all that apply.

I would like to submit a resource.
I would like to provide feedback.

SUBMIT A RESOURCE
Please include a title and brief description of the resource. You can provide a link to the resource or upload the file.

2. Title of Resource

2. Description of Resource

2. Link to Resource

2. Upload FileAllowable file types: png,gif,jpg,jpeg,doc,xls,docx,xlsx,pdf,txt,mov,mp3,mp4

File: {{filename}} delete

REQUEST A RESOURCE

2. Please describe the topic area or type of resource that you would like to see added to the TMHRC.

PROVIDE FEEDBACK

2. What feedback do you have on the TMHRC?

2. Contact Information
Please provide your contact information below (optional) and then click Submit.

First Name

Last Name

Suffix

Organization or Agency

Job Title

Discipline

Law Enforcement
Prosecution
Child Welfare
Medical
Mental Health
Victim Advocacy
Forensic Interviewing
CAC Director
MDT Facilitator
State Chapter Leader
Academia/Research
Other - Write In Please enter an 'other' value for this selection.

Phone
Please enter as 10 digits with no formatting: i.e. 8589661700 This question requires a valid number format.

Organization or Agency Mailing Address

City

State

Zip

Would you like to join the WRCAC Mailing List to receive occasional email alerts about training opportunities and resources? *