The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

Wk2zhAKuBQCJtJMPGQJFyuHhg9bvYCbLzIJrNfoppxn

Learn more and stay connected with Youth Wellness Hubs Ontario

If your community is interested in the Youth Wellness Hubs Ontario (YWHO) model and considering or working towards organizing your services to implement an Integrated Youth Services (IYS) model to serve youth aged 12-25, we would like to stay connected. Please provide your information below to receive a YWHO information package and to add your community to our communications list.

- Please note: This form is not a direct link to services. If you are seeking support from one of our hub sites, please click here to connect with your nearest hub directly.

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First name:

* must provide value

Last name:

* must provide value

Organization:

* must provide value

Position:

Location (city and/or region):

* must provide value

Email address:

* must provide value

Phone number (optional):

I am completing this survey because:

I am interested in becoming a partner organization within a YWHO network.

I want to lead the development of Integrated Youth Services (IYS) or a YWHO network in my community.

I want to stay informed about YWHO initiatives and updates.

I am a youth interested in supporting and engaging with an IYS network.

I am a family member interested in supporting and engaging with an IYS network.

I want to explore opportunities to collaborate with YWHO on youth mental health initiatives.

I am conducting research or gathering information about YWHO for a related project or grant proposal.

I am interested in learning how YWHO supports communities in developing IYS hubs.

I am seeking resources or information to help guide youth mental health services in my area.

Other (please specify).

Please provide more information here:

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.