MHSA 2012-13 Annual Update Comment Form

San Joaquin County Behavioral Health Services
Mental Health Services Act (MHSA)/Prop. 63
FY 2012-13 MHSA ANNUAL UPDATE
30-day Public Comment Form
May 18-June 17, 2012
All electronic comments and inquiries regarding the Annual Update should be sent
to: mhsacomments@sjcbhs.org
Written comments may be submitted by mail to:
MHSA Coordinator
SJC Behavioral Health Services
1212 North California Street
Stockton, CA 95202-155
All comments must be received by June 18, 2012.
A Public Hearing on the Annual Update will be held on Wednesday, June 20 at 6 pm.
The meeting will convene at the San Joaquin County Behavioral Health Services
Conference Rooms B & C
1212 North California St, Stockton
If you require special accommodations to attend (interpreters, accessible seating, childcare, sign
language or documents in alternate formats) please call 209-468-8871.
To request reasonable accommodations or translation of documents into Spanish or Cambodian,
please contact Frances Hutchins at (209) 468-8871 no later than June 4, 2012.
Para solicitar acomodacion o la traducción de los documentos mencionados en Español o
Camboyano, por favor comuníquese Frances Hutchins al (209) 468-8871.
PERSONAL INFORMATION
Name: ___________________
Agency/Organization: ________________________________
Phone Number: _______________________ E-mail address: _____________________
Mailing address: _______________________________________________
___ Client/Consumer
___ Family Member
___ Education
___ Social Services
YOUR ROLE IN THE MENTAL HEALTH SYSTEM
___ Service Provider
___ Law Enforcement/Criminal Justice
___ Probation
___ Other (specify) _______________
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San Joaquin County Behavioral Health Services
Mental Health Services Act (MHSA)/Prop. 63
FY 2012-13 MHSA ANNUAL UPDATE
30-day Public Comment Form
May 18-June 17, 2012
COMMENTS:
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