May 2026 Maternal and Infant Health Townhall Registration

Welcome! We are excited that you are attending the townhall on May 12th 2026. Please complete the following to register. This event and dinner are free of charge. There are no obligations except for providing your opinion and experience.

1. Contact Information (the information you provide will not be shared outside of this event) *This question is required.

Name
Email Address
Phone Number

2. Please enter the total number of people you would like to register to attend the Maternal and Infant Health Townhall on May 12th. *This question is required.

3. Out of all people you are registering, how many are under 12 years of age? *This question is required.

4. What county do you live in? *This question is required.

5. If anyone you are registering needs special accommodation (language interpretation/translator, dietary restrictions, ADA access, etc.) please list their full name and the type of accommodations needed below.

If more than 6 people need accommodations or if you would like to talk to someone about accommodations, please email kgarcia@dhd10.org.

Space Cell	Name	Accommodation
Person 1	Person 1: Name	Person 1: Accommodation
Person 2	Person 2: Name	Person 2: Accommodation
Person 3	Person 3: Name	Person 3: Accommodation
Person 4	Person 4: Name	Person 4: Accommodation
Person 5	Person 5: Name	Person 5: Accommodation
Person 6	Person 6: Name	Person 6: Accommodation

The townhall will include a group discussion. For the discussion, we will ask about your experiences with healthcare related to pregnancy and maternal health. This includes what worked well, what could be better, what resources you needed, and what resources helped you the most. This information will help guide us while we work to improve maternal and family health services.

You are welcome to look at and respond to the discussion questions before or during the townhall. Once you submit this registration, wait 15 seconds and the questions will appear on your screen.

Please email kgarcia@dhd10.org with any questions regarding your registration.

May 2026 Maternal and Infant Health Townhall Registration

Event Registration