State Selfies: Help Develop a Picture of Peer Services in Your State
Doors to Wellbeing, National Consumer Technical Assistance Center, is dedicated to peer support specialists.
For our new project, WE NEED YOUR HELP in collecting information on the peer services, organizations, programs, projects, groups, and networks in your state. Please answer as many questions as you can; it’s okay if you do not know all the answers. Please fill out a separate survey for each organization or program you want to tell us about. This is an ongoing project.
State (Please use abbreviation when possible.)
Please check all that apply
I identify as a person with lived experience with mental health challenges
I am a peer support specialist
I am working as a peer support specialist
I supervise peer support specialists
I run an agency that employs peer support specialist
I receive peer support specialist services
I work for a managed care organization
None of these describes me
Name of organization/agency (if not connected to an agency - please just write NA or "self")
Organization/Agency address and phone number
Is the organization/agency:
Not peer-run, but has peer-run programs
Not peer-run but has programs that are staffed by peers
Not peer-run and does not have peer staff
Please provide a description of the agency and/or program and the peer services it provides.
Organization/Agency email and website
Estimated number of staff in the organization:
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This form was created inside of Copeland Center.