ACT for Caregivers Registration Form

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Acceptance and Commitment Training (ACT) for Caregivers is a 5-week virtual group for parents and caregivers caring for or supporting a child or adult of any age living with epilepsy. Please click here to learn more.

The sessions will take place on Thursdays for 5 consecutive weeks from March 20th to April 24, 2025 (No session April 10), in the evenings from 6:00-8:00pm.

If you are a client of Epilepsy Toronto you may register for the group by completing this form. You will be contacted by a group facilitator to confirm your participation. If you are not yet connected with our organization and would like to participate, please complete the form and we will contact you to gather additional information.

A virtual orientation session recording will be provided upon receipt of this registration form. You are asked to watch the Orientation Video before committing to the group.

First name *

Last name *

Email address *

Phone number *

Home address *

Date of birth *

YYYY

I am... *

A client of Epilepsy Toronto

A client of another epilepsy agency in Ontario

Never been connected to an epilepsy agency

Are you interested in learning more about being a co-facilitator for a future cycle of ACT for Caregivers?

Yes

Not sure

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Please let us know if you have any questions or have additional information you would like to provide.

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