DON Support PODS

Interest Form

Join a DON Support Pod! Your Pod will be a small group of peers (3+ a Guide) who can give you an unbiased, safe space to vent, flourish in your profession and feel empowered. You'll meet virtually each week for 30 minutes. CHCA will try to match you with individuals near you to encourage in person engagement.

Question Title

* 1. Contact Information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 2. Years as a Director of Nursing

0-2

3-5

Question Title

* 3. Will you be able to commit to participate once a week for six months?

Yes