NAMI Billings Peer-to-Peer Registration
Peer-to-Peer is a recovery education course open to anyone experiencing a mental health challenge. This course is designed to encourage growth, healing, and recovery among participants.
* Required
Email address
*
Your email
Spring 2019 Class - Wednesdays: February 13 - April 3
LOCATION: NAMI Billings Office - 3333 2nd Ave. N, Ste 150, Billings, MT 59101
TIME: 6:00 - 8:00pm
Name
*
Your answer
Address
*
Your answer
Phone Number
*
(Please provide the best time to contact you)
Your answer
Email Address
*
Your answer
Are you currently affected by mental illness?
*
Yes
No
Required
What is your primary diagnosis?
*
Your answer
Will you need special accommodations?
Your answer
How did you hear about us?
*
Health Care Provider
NAMI Billings Email
NAMI Billings Flyer
Family member/Peer
Newspaper article
Fliers around town
Court personnel
NAMI Advocate publication
School
IOOV presentation
Other:
Required
Thank you for your interest in Peer-to-Peer. A class facilitator will be contacting you soon.
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of NAMI Billings.
Report Abuse
-
Terms of Service
Forms
