COVID-19 Mental Health Relief Scheme Application

COVID-19 精神健康援助計劃申請表格

To register your interest in this scheme, please fill out this form and a team member of ours will get back in touch with you.  如有興趣申請本次計劃,請填妥本表格,Mind HK 職員將會盡快與您聯絡。

In partnership with a group of qualified clinicians across Hong Kong’s private and public practices, Mind HK is able to help to coordinate and offer short-term pro bono mental health support, available in English and Cantonese to those impacted by quarantine restrictions, being hospitalised and other mental health stressors relating to COVID-19.

Please visit https://www.mind.org.hk/covid19reliefscheme/ for further details of this scheme.

Note: This service is not an emergency service and has not been developed to provide ‘therapy’, but to provide brief ‘guided self-help’ support for those showing early signs of emotional distress due to Covid-19. If you are struggling with more moderate to severe mental health issues, or a longstanding and enduring mental illness, or there is a risk concern due to your current mental health, then this service may not be the right type of support for you.

All personal data collected from this form will be used for the sole purposes of the administration, triage, and coordination and related processes of the COVID19 Mental Health Relief Scheme only. All data will be anonymised for scheme evaluation purposes thereafter. By submitting this form, you agree for Mind HK to use your details for the purposes listed above. You may email us at covid@mind.org.hk to request any amendment of personal information if applicable. Please visit our privacy policy for further details.

透過與香港私營及公營醫療機構合資格的臨床醫師合作,Mind HK 可幫忙協調和提供短期、無償精神健康支援,以英語及廣東話輔導形式協助因隔離限制、住院以及其他因疫情影響而出現精神壓力的人。 

有關此計劃的詳情,請參閱: https://www.mind.org.hk/zh-hant/covid19reliefscheme/

備註:計劃目的是支援一些因疫情影響出現早期情緒困擾跡象的群體。此服務並不是緊急服務,而且不會提供治療。計劃將為出現早期情緒困擾跡象的人士提供「指導式自助」支援。如果你正面對中度或重度精神健康問題、長期精神疾病,或因精神健康出現安全風險,此計劃未必符合你的需要。

此表格所收集的所有個人資料僅用於COVID-19精神健康援助計劃的行政、分類、協調,以及相關過程。 其後,所有資料都將以匿名方式進行方案評估。 提交此表格即表示您同意 Mind HK 將您的詳細資料用於上述目的。 您可以以電郵方式聯絡我們 (covid@mind.org.hk) 要求修改您的個人資料(如適用)。 請細閱我們的隱私政策了解詳情。
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