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Youth Peer Interview Interest Form
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1.
Are you currently employed as:
(Required.)
a Youth Peer Provider?
a Youth Recovery Coach?
Neither
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2.
Are you actively providing youth peer support this month?
(Required.)
Yes
No
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3.
What state/territory/tribe do you offer youth peer support in?
(Required.)
*
4.
Do you have a reliable internet connection to join a Zoom interview?
(Required.)
Yes
No
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5.
Do you have time to participate in a 45 minute Zoom interview in the next two weeks?
(Required.)
Yes
No
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6.
Please select all that apply:
(Required.)
I am currently working from home
I am currently going in to the office to work
I am meeting with youth on a virtual platform
I am meeting with youth in person
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7.
What age category do you fall in?
(Required.)
16-20
21-25
25-29
Over 30
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8.
What age youth do you provide peer support to?
Please select all that apply.
(Required.)
13-17
18-21
22-26
Over 27
Current Progress,
0 of 16 answered
