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F2F Interest Form

NAMI Family-to-Family is a free, 8-session educational program for family and other caregivers of people living with mental illness. The course is taught by NAMI-trained family members who have been there, and includes presentations, discussion and interactive exercises. In the program, you will learn about:

-How to manage crises, solve problems and communicate effectively
-Taking care of yourself and managing your stress
-Developing the confidence and stamina to provide support with compassion
-Finding and using local supports and services
-Up-to-date information on mental health conditions and how they affect the brain
-Current treatments, including evidence-based therapies, medications and side effects
-The impact of mental illness on the entire family

**Please note the time commitment required to participate in the Family-to-Family program. It is important that participants show up each week over the 8 week period. If you will miss more than 1 or 2 classes, consider waiting until the next class to see if it better fits with your schedule.
1.First Name
2.Last Name
3.Phone Number
4.Email Address
5.Mailing Address
6.What is your relationship to your loved one with mental illness?
7.Will someone else be joining you? (spouse, child, etc.)
8.If yes, what is their full name and email address?
9.If yes, what is their relationship to your loved one with mental illness?
10.What is your loved one's primary diagnosis?
11.Is your loved one a Veteran who is receiving services from VHA?
12.Why do you want to participate in the Family-to-Family class?
13.Are you able to make the time commitment to attend each class over the course of 12 weeks?
14.How do you feel your family member is doing right now?
15.How do you feel you are doing right now?
16.Do you feel you can participate in a modeled or structured program? Do you understand the role of the facilitators is not to give medical advice to anyone participating?
17.Are there any special needs or considerations we should know about when considering your application? (lack of transportation, handicapped, other limiting concerns)
18.Do you have your own transportation? If no, do you use public transportation?
19.Do you feel comfortable reading out loud to others from written text?
20.Additional comments: