2021 MHLG Organization Contacts

Thank you for your ongoing participation in the Mental Health Liaison Group. I am updating the contacts for the MHLG for 2021. This updated list will be used for sending email communications from the MHLG board members throughout 2021. Therefore to ensure that you continue to receive communication, please take a few moments to update your organization’s information.

First Name:

Last Name:

Email:

Organization Name:

Organization Address:

Are you still a member of MHLG?
YesNo. Please remove all contacts from the MHLG list.

Type of Membership:
FullAffiliate(not applicable)

If you have additional contacts to add, please do so below.

ADDITIONAL CONTACT 1:

First Name:

Last Name:

Email:

ADDITIONAL CONTACT 2:

First Name:

Last Name:

Email:

ADDITIONAL CONTACT 3:

First Name:

Last Name:

Email:

Thank you for your assistance in enabling us to provide improved service and ensuring no disruption in communication to your organization.