NAMI Southwest Iowa Thursday Connection Form
Thursday Connection Meeting 6:30 - 8:00 PM  (if you'd like to participate during a different day and time, please specify that in the last question of this form)
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Email *
Your Name *
Your Address
Your phone number *
Your emergency contact *
Emergency contact number *
Have you attended a support group before?
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All NAMI support group members must be 18 years or older *
The Zoom platform we will be using will be a private meeting, however it is not HIPPA approved and NAMI SW Iowa cannot guarantee confidentiality of information you share during the support group meetings held virtually. *
Anything else you'd like the organizer of this support group to know about you? If you have specific questions you can also enter them here.
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