Please fill in the below form to be included in the EPA list of mental health professionals who volunteer to give support to people affected by the conflict in Ukraine. Thank you.  

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* 1. Name

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* 2. Surname

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* 3. email address

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* 4. Country where you work

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* 5. Spoken languages

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* 6. If you are a psychiatrist, please select the field(s) that applies to your work below:

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* 7. If you are a psychologist, please select the field(s) that applies to your work below:

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* 8. Please specify your area(s) of expertise:

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* 9. The EPA is also organising initiatives to provide peers/helpers with the necessary knowledge and supervision to give psychosocial support to people in need. 
Are you willing to be contacted to provide support and supervise the "helpers"?

One additional step to submit your data:
For GDPR purposes, the EPA asks you to:
  • Download the GDPR Consent Form by clicking on this link.
  • Complete and sign the Form
  • Send the completed Form back to epa.brussels@europsy.net 
Thank you!

You can now submit your data.

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