System of Care Collaborative Interest Form
The System of Care Collaborative bring together parents, youth, providers and administrators to problem-solve barriers in the systems of care. By participating, you are using your voice to help impact how the county serves families, youth and children with mental health challenges.
• the parent/caregiver of a child or adolescent who is the recipient of high levels of mental health services through Multnomah County and/or Wraparound services, within the last 2 years;
• and/or your child members of Health Share; AND
• ready, willing and able to share some of your stories, barriers and experiences in order to advocate for and effect change?
Please fill out this form, and we will get back to you shortly. We are so looking forward to working with you!
Questions? Contact Dana at
Care Coordinator (if applicable)
Family Partner (if applicable)
NAMI Multnomah (National Alliance on Mental Illness)
OFSN (Oregon Family Support Network)
The following applies to me and/or and my family (check any/all that apply):
I am the parent and/or caregiver of a child or adolescent who is CURRENTLY receiving high levels of mental health services through Multnomah County.
I am the parent and/or caregiver of a child or adolescent who is CURRENTLY receiving Multnomah County Wraparound services.
I am the parent and/or caregiver of a child or adolescent who FORMALLY received high levels of mental health services through Multnomah County within the last 2 years.
I am the parent and/or caregiver of a child or adolescent who FORMALLY received Multnomah County Wraparound services within the last 2 years.
I and/or my child are members of the Oregon Health Plan (OHP).
WE WANT TO HEAR YOUR VOICE! Please briefly explain what interests you about participating in the mental health advocacy for youth and family. Questions? Let us know!
By writing my full name below, I am expressing interest in participating in the Multnomah County System of Care Collaborative. NAMI Multnomah is authorized to have a representative contact me to discuss further details.
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