Detroit Perinatal Wellness Coalition: Resource Guide Submissions
Please fill out this survey to be considered for inclusion in the DPWC Resource Guide, which compiles professionals from a variety of fields in the Metro Detroit area that specialize in perinatal mood disorders and reproductive loss. Thank you for all you do and we look forward to connecting you with moms and dads in need of support!

If you have any questions or would like to share a flyer or brochure, please e-mail detroitpwc@gmail.com.

This survey should take about 10-15 minutes to complete.

Name of Organization or Program *
Your answer
Main Contact Person for Clients *
Your answer
Address *
Your answer
Phone Number *
Your answer
E-Mail *
Your answer
Website
Your answer
Type of Service (choose all that apply) *
Required
Payment Options *
Required
What insurances do you accept? If none, what is the typical cost for services? *
Your answer
Logistical Supports for Families
Summary of Services Provided *
Your answer
Eligibility Requirements (if any). Include any restrictions on age, gender, or geographical location. *
Your answer
How do new clients enroll? (Please be as specific as possible. Can clients drop-in or must the register? Who should they contact? How long is the waiting list? What documents do they need?) *
Your answer
What specific training or experience do you have that qualifies you to treat perinatal mood disorders or reproductive loss? *
Your answer
Have you completed Postpartum Support International's 2-Day Perinatal Mood Disorders Training? *
Is there anything else clients should know about your program? *
Your answer
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