Peer Support Interest Survey

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Hello! Welcome to Training 4 Transformation's Peer Support Community!

Training 4 Transformation offers free weekly online peer support groups and training opportunities. We also offer virtual tech support. Peer Support is an opportunity to gather with a group of people who share similar experiences. In Peer Support groups, we create a comfortable space to share about thoughts, feelings, frustrations, successes, and what we want for our lives.

Please fill out this form and we will be in touch with you soon!

Please provide your full name. *

This information will remain confidential and will not be shared with any external party.

What is your email address? *

This information will remain confidential and will not be shared with any external party.

What is your phone number?

This information will remain confidential and will not be shared with any external party.

What is the best way to reach you? *

Phone call

Are you 18 years of age or older? *

Yes

Have you ever used a video conferencing app (like Zoom, Messenger, FaceTime, WhatsApp)?

Yes

No, but I would be willing to learn!

Clear selection

Select all that apply *

I have an intellectual disability.

I have a developmental disability (diagnosed before age 22).

I have paralysis.

I have mobility issues.

I do not have an intellectual and/or developmental disability and I do not have paralysis.

Required

What county do you live in? *

Select all that apply. *

Peer Support is an opportunity to gather with a group of people who share similar experiences. In Peer Support groups, we create a comfortable space to share about thoughts, feelings, frustrations, successes, and what we want for our lives.

I have never been to peer support.

I need tech support to join (access to a computer, wifi, or help getting connected).

I would love to join an online support group where I can connect with others.

I have joined peer support groups before (online or in person).

I am interested in training to host online peer support.

I am interested in in-person groups

I am interested in training to host in-person groups

Required

What times work best for you?

All times are listed in CST.

Mondays 3:30-4:44

Wednesdays 3:30-4:44

Thursdays 3:00-4:30

Thursdays 5:30-6:30

Fridays 3:30-4:44

Other:

What Peer Groups are you interested in?

The Front Porch - All Inclusive / All Abilities Peer Group

The Healing Circle - for Mental Wellness

PRESENCE Group for peers with Intellectual Disabilities

Adapting Sheros for women with Mobility Disabilities

Speech Device Users Peer Group

Spanish Speaking Peer Group

Spiritual Care Circle

Meet with the Channels 4 Self-Advocacy Team, to share a challenge I want to work through!

I would like to help start a Men with Disabilities Peer Group!

I wish there were a group to support People with disabilities and their partners. A Relationship group.

Other:

Any Questions you would like to ask, or ideas you would like to share?

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