Project LETS: Peer Support & Advocacy Services General Intake Form

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Project LETS: Peer Support & Advocacy Services General Intake Form

Fill out this form if: you are looking to work with/receive support from Project LETS.

Please note: We are a small team of Disabled, Mad, and neurodivergent folks with varying capacity and response times. We will be in touch as soon as possible. If your request is time-sensitive, there is a place to indicate that on the form. We may not be able to work with or provide services to everybody who fills out this form.

Access: You may also submit your responses via email to support@projectlets.org in text, audio, or video form.

Questions? E-mail stefanie@projectlets.org

What is your name and pronouns? *

What is your email? *

What is the best way to contact you? *

What type of support are you looking for? *

If what you're looking for is not listed, please fill out Other

1:1 Peer Support

Group Peer Support

Crisis support

Advocacy Services (education discrimination, mental health or medical system, family services, etc.)

Support during or after a psychiatric hospitalization

Supporting someone else experiencing a mental health crisis

Mediation or conflict intervention

Non-medicalized healing resources or practitioners

Spiritual and holistic support

Connection to clinical mental health providers

Connection to support groups or additional resources

Other:

Required

Please expand on the above question: What type of support are you looking for?

What brings you here? What do you need? What gaps of care have been existing for you? What are you hoping for? What goals do you have?

Is your support request time-sensitive?

Yes

Unsure

Other:

Clear selection

Please share any access needs you would like Project LETS team members to be aware of in order to communicate with you.

Please describe any parts of yourself or your identity that feel important to share.

Are you looking to connect with anyone of a specific identity or shared experience?

Please note: We will not always be able to make these matches, and will communicate about what your options are and who is available to work with you.

Do you have any additional background or context you'd like to share about yourself or your experiences?

Questions or concerns?

Submit

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