Are you interested in collaborating with others to achieve the shared mission of eradicating dental disease among Maine children? If so, please tell us about your interests.
* Required
Name
*
Your answer
Email
*
Your answer
Your Organization(s) and Role(s)
Your answer
Phone number
Your answer
When you think about your role in the oral health system and look at the Partnership's Roadmap (
https://www.mainepcoh.org/img/pcoh-roadmap-2018-08-01.pdf
), is there anything that you are most interested in learning or doing with others in the next 6-12 months?
Your answer
What types of involvement would you find most interesting/valuable?
Get occasional updates on Partnership activity through the Maine Oral Health Coalition or other regular newsletters or meetings (suggest specifics under next question)
Google group or listserv to share info, questions with broader network
Occasional larger work sessions focused on design or strategy conversations
Occasional smaller gatherings on specific topics, to learn and provide input (in-person or Zoom)
Regional convening of partners in my county/district/region to discuss opportunities to improve oral health systems locally
Unstructured or semi-structured networking opportunities (statewide or more local?)
Peer consultations to share challenges/ideas and get feedback/advice from thought partners
Join an action team or workgroup on: (write specifics under next question)
Lead an action team or workgroup on: (write specifics under next question)
Other:
Write any specifics here to explain your answers to the previous question:
Your answer
Do you have any other comments or questions to share?
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of mainepcoh.org.
Report Abuse
-
Terms of Service
Forms
