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Mental Health Strong - New Member Form

This brief survey is to help us understand the background of each person in the support group, identify trends and potential research before one learns the Mental Health Strong tools. Your personal information is confidential, will not be shared outside MHS and is gathered only to add you to the MHS communications that you can at any point opt out of. Thank you again for your valuable input so that we can continuously bring hope, resources and support to marriages with mental health and addiction challenges.
1.Name(Required.)
2.Email(Required.)
3.Phone Number(Required.)
4.What are your social media handles?
5.Where do you live in general? (State, Country)
6.Do you have children?
7.How long have you been married?
8.What condition(s) or addictions does your spouse have (click all that apply)?(Required.)
9.What stage of the marriage are you in wiith a mental health or addiction challenge?(Required.)
10.On a scale of 1-5, how hopeful and skilled do you feel about your marriage making it and not obtaining a divorce?(Required.)
11.What is your faith (it is ok if you don't have one)?(Required.)
12.What is the main item that you are looking to gain from the MHS Community?(Required.)
13.How did you hear about Mental Health Strong?(Required.)
14.Additional Comments / Suggestions / Needs / Questions
Current Progress,
0 of 14 answered