Family-to-Family Education Program Interest Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please complete the interest form below. One of our Family-to-Family facilitators will contact you to finalize your registration.

NAMI Family-to-Family is a free, 8-session educational program for family, significant others and friends of individuals with mental health conditions. It is a designated evidenced-based program. This means that research shows that the program significantly improves the coping and problem-solving abilities of the people closest to a person with a mental health condition.

NAMI Family-to-Family is taught by NAMI-trained family members who have been there, and includes presentations, discussions and interactive exercises.

More Information can be found at this link:

NAMI, PA MAIN LINE Family-to-Family and Basics Education Programs | NAMI MAIN LINE PA

Email *

Are you a family member, significant other or a friend of someone with a mental health condition?

Yes

Clear selection

Name:

Phone number:

Email:

Do you prefer in-person or virtual? (Please select one or both)

Virtual

In-person

Clear selection

Home Address:

City:

State:

Zip:

Please tell us more about your family member, significant other or friend and why you are interested in taking the Family-to-Family class.

Best times to reach you:

How did you hear about this class?

Would you like to be added to our newsletter?

Yes

Clear selection

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Jen Office Coordinator.

Does this form look suspicious? Report

Forms