NAMI Basics is a free, 6-session educational program for family and other caregivers of children and/or adolescents living with mental illness. The course is taught by NAMI-trained family members who have been there and includes presentations, discussion, and interactive exercises.

**It is important that participants show up each week over the 6 week period.

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* 1. First & Last Name

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* 2. Best Contact Number

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* 3. Email Address

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* 4. Mailing Address

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* 5. The person with the mental health condition is your...

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* 6. How old is the person with a mental health condition?

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* 7. What is the type of mental health condition/behavioral difficulties of the person?

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* 8. This person lives...

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* 9. Why do you want to participate in the Basics course?

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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 additional comments or questions.

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