Name *

First Name

Last Name

What kind of 'helper' best describes you? *

If none applies to you, please describe in the field below.

Registered Psychotherapist

Registered Psychotherapist Qualifying

Registered Social Worker

Masters of Social Work Student

Mental Health Counsellor

Other Mental Health Professional

Registered Nurse

Nursing Student

Other Health Care Professional

Midwife

Doula

Breastfeeding Consultant

Sleep Consultant

Other Maternal Health Care Provider

Educator/Teacher

Other Kind of Helper (describe below)

What are you looking for from this Professional Collaboration Group? *

Please select all that apply and/or describe in the field below.

Mentorship Opportunities (to be a Mentor)

Mentee Opportunities (to connect with a Mentor)

Training Opportunities (to teach/train others)

Learning Opportunities (to receive training)

Resource Opportunities (to share resources)

Promotional Opportunities (to cross promote services)

Collaboration Opportunities (to combine services)

Networking Opportunities (to connect with colleagues)

OTHER (please describe)

What interests you? *

Please select all that apply and/or describe in the field below.

Clinical consultations / advice on cases

Content and resources for 'helper' professional mental health

An online chat group for colleagues

Training courses

'Lunch and Learn' webinars

Workshops

Seminars

Online resource guide for 'helper professionals'

Online referral listing of 'helper professionals' for related services

Cross promotion of services through content, workshops or 'take-overs'

Collaborating to combine services through courses, seminars or workshops

OTHER (please describe)

What topics interest you? *

Please select all that apply and/or describe in the field below.

Q&A type advice from colleagues

Professional stress, anxiety and burnout

Other mental health issues as a 'helper professional'

Social issues (diversity, equality, poverty, etc.,)

Governmental issues

Workplace issues

How to run a private practice

How to run a freelance practice/service

Branding and marketing

Interdisciplinary and interprofessional collaboration

OTHER (please describe)