MHQP Consumer Health Council Application

If you are interested in becoming a member of the MHQP Consumer Health Council, please complete the following application and we will be in touch.
Click here to learn more about how you can make an impact by joining the Consumer Health Council.

1. Applicant Information:

Where is your primary residence in Massachusetts? *

2. Briefly explain your reasons for wanting to join MHQP’s Consumer Health Council. Please describe any relevant experience (including lived and/or professional), what you hope to gain from being on the Council, what you will bring to the Council, and anything else you would like to share. *

3. MHQP welcomes and values the diverse identities and lived experiences of our Council members. If you feel comfortable, please tell us about your background, identity, or anything else that helps us understand who you are.

4. How did you hear about MHQP’s Consumer Health Council?