The CHAN Project Community Input Survey

Thank you for helping us determine how best to support our community's healing...

The CHAN Project is a newly forming nonprofit based in Snohomish County. The purpose of the CHAN Project, is to expand Compassion, Healing, Awareness and Nurturing to our community by supporting those experiencing grief and loss, struggling with mental/emotional wellness, families touched by substance use or unhealthy relationships, and much more.

The CHAN Project, which started because of one family's great loss from the opioid epidemic, aims to understand our community needs and share wisdom to help heal and prevent the same pain around emotional wellness, behavioral and mental health, loss, and more.

Whether it's low self -esteem, isolation, depression/anxiety, social media bullying, relationships, grief and loss, maneuvering the journey of a loved one's substance use, struggling with your own mental wellness, or experiencing any other form of social or emotional health needs. The CHAN project is here to fill the gaps in services that the community identifies.

Our work is based on diversity and inclusivity, and we are a non-faith-based practice that welcomes all faiths. Most of all, we welcome your feedback to help in the process of forming our programs. Our first three programs in the developmental stages include:

Opioid and Fentanyl Awareness Programs (in Schools)

Grief Circles (Hybrid Format - Virtual and in Person)

CHAN Podcast and CHAN Blog (Spotify, iTunes or wherever you get your podcasts, and Online)

This survey will help us structure the programs above, and determine which upcoming programs to prioritize. Thank you for your time and input as one of our potential participants.

Humbly,

The CHAN Project

Compassionate, Healing, Awareness and Nurturing Project

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Question Title

* 1. What is your age?

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* 2. Would you be interested in any of the following services ? Please check all that apply:

In person meetings/groups

Podcasts

Grief and Loss Support (Grief Circles/Groups)

Substance Use Support

Online meetings (i.e. zoom or other)

Mobile App

Blog

Reiki, Yoga, Meditation or other classes

Art as therapy or healing (i.e. Zentangle, graffiti, music therapy etc)

Town Halls, Speakers forums - Awareness Groups

Other (please specify)

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* 3. This section below is based around needs for individuals facing struggles with grief and loss. If you are currently experiencing grief or loss for any reason, please share some of your interests and needs with us below:

	Grieving	Death by	Loss from	Other Forms of Loss
My needs include:	My needs include: Grieving menu	My needs include: Death by menu	My needs include: Loss from menu	My needs include: Other Forms of Loss menu

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* 4. What is your biggest barrier in seeking services?

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* 5. If you would like to be placed on our mailing list, please enter your contact information below.

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 6. Demographic information helps us identify what areas to provide services. Please provide your location where you would be accessing services.

	City/Location
Location	Location City/Location menu