MHW

Organization*

Type of organization*

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Number of employees*

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First Name*

Last Name*

Job Title*

Email*

Phone Number*

Phone

Business Address*

City/Region*

Timeline*

Provide us with an estimated date/timeline for these workshops. Please note that we usually need four weeks to book a workshop.

Reason for booking the workshops*

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If other, please expand:

Offered mental health trainings in the past*

Has your organization offered mental health trainings in the past year?

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How did you hear about us?*

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Post workshop follow-up*

This would involve a short survey six months to a year after the workshop has been delivered to follow up on the impact of the workshop in your workplace. This will help us with continuous program improvement.

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