Alpine County, CA · Alpine County
MHSA Program Evaluation Form
This form lets Alpine County program attendees share feedback about an MHSA program and suggest changes for future programs.
At a glance
- Issued by
- City of Alpine County · Alpine County, Alpine County, California
- Notarization
- Not required: file this form without a notary.
- Official source
- alpinecountyca.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Attendees use this form to evaluate an MHSA program by naming the program and the date they attended, then answering questions about what they liked and what could be done differently. The form also provides an optional space for a name and contact information. It can be returned to a Behavioral Health Services Office in Alpine County.
Who needs it
People who attended an MHSA program and want to share feedback with Alpine County Behavioral Health Services can complete this form.
How to submit it
Return the form to any Behavioral Health Services Office in Alpine County: 75C Diamond Valley Rd, the Firehouse at Hung-A-Lel ti, or the Community Building in Bear Valley. For more information, call 530.694.1816.
About notarization
This form is completed without a notary; it mentions no notarized attachment or sworn step and asks for program information and feedback.
How to submit this form
- 1
Download the Form
Download the MHSA Program Evaluation Form.
- 2
Complete the Form
Provide the program name and attendance date, answer both feedback questions, and add your name and contact information if you wish.
- 3
Return It to the County
Return the form to any Behavioral Health Services Office in Alpine County at one of the locations listed on the form.
Frequently asked questions
- Do I need a notary for the MHSA Program Evaluation Form?
- No. The form does not require notarization and mentions no notarized attachment or sworn step.
- How do I submit the MHSA Program Evaluation Form?
- Return it to any Behavioral Health Services Office in Alpine County, including the listed locations at 75C Diamond Valley Rd, the Firehouse at Hung-A-Lel ti, or the Community Building in Bear Valley.
- What information does the form request?
- It asks for the program name and date attended, feedback about what you liked and what could be done differently, and optional name and contact information.