H.E.A.L Connecting with Stakeholders

H.E.A.L Connecting with Stakeholders

Join us for the Stakeholders Meeting for the Health Equity Action for Lactation (HEAL): Breastfeeding Program for African American Mothers and their Families! All whose work impacts African American/Black families are invited to engage and learn about this project.
Name*

First NameLast Name
Email*
example@example.com
Have your previously attended a HEAL Stakeholder Meeting*

YesNo
Would you like to join our E-Mail/Newsletter List?*

YesNo
Phone Number
Please enter a valid phone number.
Is the phone number you provided a mobile number?

YesNo
Would you be interested in phone/text messaging updates?

YesNo
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Organization/Company (If applicable)
Your Stakeholder Identity. (Check all that do apply)*

Pregnant or Lactating WomanParenting PersonBirth WorkerCommunity-Based Organization Staff/MemberCommunity Health WorkerAllied Health StaffLactation Support SpecialistLocal/State/Federal Government EmployeeNational Organization Staff/MemberNurseNutritionistPharmacistPrimary Care Provider (Physician, Midwife, Nurse-Practitioner, etc)Public Health Agency StaffPublic Policy/AdvocacyResearcherSocial WorkerStudentOther
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