The Philippine Nurses Association of Metro DC (PNAMDC) in collaboration with the Philippine Medical Association of Metropolitan Washington, DC (PMAMWDC) Heal the Healer Project is delighted that you are interested in participating in our online peer-to-peer support group.

The Peer-to-peer support group contributes to increasing well-being by fostering healing and growth in a contained, safe and non-judgmental environment. The interpersonal process support groups provide, allow people to experience increased self-awareness and feelings of connection. While therapeutic, please
understand that support groups are not therapy. If the facilitator feels that additional therapy may be
beneficial in your case, you will receive guidance upon your approval.

The group will facilitate 4 virtual sessions. You may attend 1 or more sessions.
The dates are as follows:

Session 1 January 29, 2022 (Saturday) 1600-1715
Session 2 TBD
Session 3 TBD
Session 4 TBD

Each session is 60 to 75 minutes long depending on the number of participants.
To participate, you must be an Asian American health care worker in any capacity.

The following are some guidelines that foster a safe, rewarding group experience:

1. Confidentiality
We ask that everything said in the group remains confidential and that you agree to not
reveal the identity of other group members to anyone outside the group. Although everyone
is expected to maintain confidentiality, we have no control over the actual actions of others.
Please talk to your facilitators if you have any concerns regarding confidentiality.

Limitations to confidentiality occur in the event of:
A member expressing intent to harm themselves or others
Suspected child abuse or neglect
Suspected elder abuse or neglect
Suspected abuse of a disabled individual

2. Respect
A. Be thoughtful and intentional in providing and responding to feedback.
We are here to help, not judge, each other.
B. Please respect individual differences
C. Everyone has the right to speak and to be heard. Please express disagreement and
strong emotions such as anger in a way that does not threaten or intimidate others.

3. Time
A. Notice how much you talk and how much you listen, allowing space for everyone in the group.
B. Group facilitators will strive to begin and end on time.

4. Attendance
A. We request that you commit to your signed-up schedule. If you are going to be absent,
please notify mizpahamados03@gmail.com 48 hours in advance.
B. Log in with enough time before each session.

5. Avoid comparing the significance of problems. Everyone’s distress is valid.

6. You agree to not use mind or mood-altering substances, including alcohol, prior to group meetings.

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This support group is facilitated by a licensed/trained clinician(s). They are committed to inclusion and multicultural appreciation.The following facilitators have received training and some of them have previously facilitated a peer
support group with the Philippine Nurses Association of Metro DC (PNAMDC).
Mizpah Amados MSN, PMHNP-BC
Joy Arellano BSN, RN
Lourdes Careaga MSN, RN CMSRN, NE-BC
Efigenia Geli-Geocadin, MD, MPH
                                                                               Practicing Psychiatrist in Baltimore, MD
In order for our facilitators to know you and for your safety, we require you to complete this registration form.
This information is obtained for record purposes only and will not be shared with third parties.
First Name *
Last Name *
Email Address *
Zip Code *
Employer/Organization's ZIP CODE *
Role in the Organization
Can you meet in a secure space uninterrupted for the duration of the session? *
Check the checkbox. *
Referring to the question above, please initial. *
Check the checkbox *
Referring to the question above, please initial. *
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