Courage to Caregivers One-to-One Caregiver Support Program Application
Recognizing that self-care is the “oxygen mask” for the mental illness caregiver, Courage to Caregivers is accepting applications for volunteers and participants in the launch of its One-to-One Caregiver Support program.

The program connects caregivers with volunteers who have experience caring for someone with a mental illness. The purpose of the program is to provide participants with training and resources to help them take care of themselves both physically and emotionally so they are better able to take care of someone else.

Acknowledgement *
I understand that Courage to Caregivers, its officers, directors, employees, and those volunteers in this program do not provide medical advice. Nothing provided by Courage to Caregivers or the volunteers in this program either through the program or through the other materials or website of Courage to Caregivers, are to be considered as medical advice and any information I provide through this program or from other Courage to Caregivers materials should not be considered as such. I acknowledge I am providing information about myself and those I support's medical condition(s) voluntarily and understand that such information is collected in Courage to Caregiver’s secure database. This information is accessible by Courage to Caregivers employees only.
First name *
Last name *
Email address *
Telephone number *
Are you applying to be a: *
Never submit passwords through Google Forms.
This form was created inside of Courage to Caregivers. - Terms of Service