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AIMHC application

Industry leaders, technologists, researchers, legal experts, and similar professionals.

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Section 1

This application is for industry leaders, builders, academics, legal experts, and similar professionals.

*If you are a CLINICIAN, please back out of this application and complete the "Clinician's Circle" application instead*

Question 2 of 14

Name

Question 3 of 14

Today's Date

Question 4 of 14

Email

Question 5 of 14

City, State, Country of Residence

Question 6 of 14

Your current professional role in relation to your interest in AI and mental health.

Question 7 of 14

Your experience and/or education relevant to the AI mental health space.

Section 2

AI Mental Health Collective Interest

Question 9 of 14

How did you hear about the AI Mental Health Collective?

Question 10 of 14

What interests you about joining the Collective?

Question 11 of 14

Are you applying solo or are you interested in your whole team joining the Collective? If team, how many members total?

Question 12 of 14

Any additional comments or questions?

Question 13 of 14

By writing my full name I attest that the information provided is true.

Thank You!

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