ClusterBuddies Support Giver Application

ClusterBuddies is a one-on-one peer-to-peer support program. ClusterBusters has learned one of the greatest resources of our community is connecting to others who also experience cluster headache. ClusterBuddies is formalizing the process of connecting those who are experienced in navigating our disease and community with those looking to connect for support. 

Thank you for requesting to connect with our ClusterBuddies program as a Support Giver.


We’d like a little information to help us connect you with a suitable person so that you can form a good connection.

Please complete this questionnaire below and answer as many questions as you feel comfortable answering. Check as many boxes as you feel are appropriate. We will get back with you as soon as possible. 

If you have any questions please reach out to clusterbuddies@clusterbusters.org


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Disclaimers: 

Expectations for our Givers

What to do if you Buddy needs professional/emergency help:  call the National Crisis Hotline at 988 or 1-800-273-TALK (800-273-8255)  , 911, or another resource from the crisis resource section. If this becomes necessary, also email: clusterbuddies@clusterbusters.org and this will alert our team to check in with you. 

Remember self care and making sure you have support and know how to access support with us. Do not be afraid to ask for help from our team.


 *
First Name/Nickname/Handle *
Last name *
What is your gender?
Clear selection
Email address you prefer to be contacted at for this program: 
Mobile number you prefer to be contacted at for this program: (Include country code if outside the US)
Are you able to do video meetings/calls?
Clear selection
What languages can you comfortably communicate in?
Clear selection
If you can communicate in a language other than English, please list:
City
State/Province
Country
Are your cluster headaches Episodic or Chronic? 
Clear selection
How long have you had cluster headache? 
In what areas are you comfortable giving support and information? Check all that apply
Do you have a preference for gender of your Buddy?
Clear selection
Write a small introduction about yourself that I can share with the Buddy I pair you with when I introduce you in email.
Any information you want to share about yourself to help us match you with the right buddy?
Submit
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