Please note: This class is intended for friends and family members of Service Members and Veterans, not Service Members or Veterans themselves. Service Members and Veterans may find our Peer-to-Peer class helpful.

Please note the time commitment required to participate in the Homefront program. It is important that participants show up each week over the 6 week period.

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* 1. First Name

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* 2. Last Name

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* 3. Best Contact Number

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* 4. Email Address

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* 5. Mailing Address

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* 6. Are you a family member, legal guardian, household member, or caregiver of a Service Member or Veteran receiving services from the VA?

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* 7. In what branch of the military did the individual living with mental illness serve?*

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* 8. What is your relationship to your loved one with mental illness?

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* 9. What is your loved one's diagnosis?  Check all that apply.

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* 10. Are you comfortable talking with others in a group setting about your experience?

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* 11. Do you agree to keep other individuals' stories confidential?

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* 12. Please list any other information you'd like us to know.

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