Youth Mental Health First Aid (YMHFA) Training Request Form
YMHFA is an 8 hour workshop lead by two trained instructors. Material will cover information on mental health literacy, adolescent development, anti-stigma messaging and a 5 step process to support youth with a mental health crisis and suicidality. Participants will learn the signs of a mental health crisis and have the information to refer to outside resources. This workshop is ideal for those having contact with youth aged 12-25. Examples include: teachers, aids, bus drivers, school support staff, coaches, juvenile justice workers, employers of youth, faith-based communities and youth organizations.
Email address
Name of Contact Person:
Your answer
Contact Phone:
Your answer
Address (Street, City, State, Zip):
Your answer
Name of District/Agency/Community Hosting Training:
Your answer
How did you hear about YMHFA?
Your answer
The host site must agree to the following conditions. Indicate your agreement by checking the box.
Required
Lunch and Refreshments (Select all the apply)
Please share what other things you and your community are doing to support the needs of children with mental health issues (some examples may include: implementing PBIS, other trainings, a coalition of cross-systems meeting on a regular basis, e.g.):
Your answer
Please list a date that you would like YMHFA Training: (We will do our best to accommodate)
Your answer
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This form was created inside of Cooperative Education Service Agency #4. Report Abuse - Terms of Service - Additional Terms