Perinatal Mental Health Expert Team

Thank you for your interest in joining the 2028 PQCNC Perinatal Mental Health Project Expert Team!

Members of the Expert Team will come together on a monthly basis to help guide the direction and deliverables for the Perinatal Mental Heath Project.

1. Your Name: *This question is required.

2. Your Facility/Organization Name: *This question is required.

3. Please select which best describes your current role: *This question is required.

Administration & Leadership
Allied Health & Support Services
Nursing
Patient, Family, and/or Community Partner
Physician/Advanced Practice Provider
Quality, Safety, & Data
Other - Write In (Required) Please enter an 'other' value for this selection. * This question is required.

4. Your Work Email Address: *This question is required. This question requires a valid email address.

5. Your Work Phone Number: *This question is required.

6. Please share any questions, comments, or additional information: