MCPS EAP Caregiver Support Group 2022-2023 Interest Form

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Hello! Please complete this short form if you are interested in receiving emails about the MCPS Employee Assistance Program's Caregiver Support Group during the 2022-2023 school year. You may also call the EAP at 240-314-1040 or email Megan_R_Connaughton@mcpsmd.org.

*Note, members who received emails about the Caregiver Support Group during the 2021-2022 school year do not need to complete this survey.

First and Last Name *

Alternative Email (optional)

I am a *

MCPS Employee

MCPS Retiree

Adult household member of an MCPS Employee or Retiree

I am caring for a *

Loved one with dementia/Alzheimer's

Aging parent or relative

Sick family member

Adult child with mental or physical illness

Disabled family member

Other:

Required

I understand that I will receive emails about Caregiver Support Group meetings and events with guest speakers. I can request to be taken off this email list at any time by calling the EAP at 240-314-1040 or emailing Megan_R_Connaughton@mcpsmd.org. *

Yes.

Send me a copy of my responses.

Submit

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