Glenwood Springs COACT CO Focus Group Sign-Up

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COACT Colorado is partnering with the University of Colorado to conduct a statewide assessment of the current strengths and needs for child, adolescent, and transition age youth behavioral health services in Colorado.

If you are a family member or caregiver of a child, teen or young adult (aged 0-25) who is experiencing a behavioral health issue, you can help us identify opportunities for improving and expanding behavioral health services in your community by participating in a 1.5 hour focus group. Focus group participants will receive a $60 Visa gift card. We will also provide food and childcare.

A focus group in your community is planned for October 22, 2018 from 6:00-7:30 PM at the Glenwood Springs Branch Library, 815 Cooper Avenue, Glenwood Springs , CO 81601. If you would like to participate, please complete the form below. Thank you!

First and Last Name *

Phone Number *

Email Address (optional)

Do you need child care during the focus group? *

Yes

Maybe

Do you have food allergies or other dietary restrictions? (please explain)

How would you like us to contact you to confirm your attendance? *

Send me a text message at the phone number listed above.

Call me at the phone number listed above.

Email me at the email address listed above.

Other:

Required

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