Industry leaders, technologists, researchers, legal experts, and similar professionals.
Click the button below to start.
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 16
Name
Question 3 of 16
Today's Date
Question 4 of 16
Your Professional Email
Question 5 of 16
City of Residence
Question 6 of 16
State/Region of Residence
Question 7 of 16
Country of Residence
Question 8 of 16
Your current professional title
Question 9 of 16
Your experience and/or education relevant to the AI mental health space.
AI Mental Health Collective Interest
Question 11 of 16
How did you hear about the AI Mental Health Collective?
Question 12 of 16
You're almost done with the application process!... What interests you about joining the Collective?
Question 13 of 16
Please share your LinkedIn profile and/or website.
Question 14 of 16
Any additional comments or questions?
Question 15 of 16
By writing my full name I attest that the information provided is true.
Please click the final SUBMIT button to ensure we receive your application.
We will be in touch within the next 1-3 business days!