Individual (1-to-1) Peer Support Application
If you are within the perinatal period (trying to conceive a baby through to conception two years postpartum) and want to be paired with a Peer Support Volunteer, please complete the following application and someone from our team will be in touch with you via email.

Please note: If completing application is a barrier to participating in the Peer Support Program, or you would like to apply over the phone, please email peersupport@perinatalwellbeing.ca to set up an appointment.

The following information is collected for the purposes of intake to the Peer Support Program. Sections of this application are OPTIONAL but are used to help us match you with a Peer Support Volunteer more accurately. Perinatal Wellbeing Ontario will not contact you or retain this information for any other reason.
We look forward to learning more about you.

IMPORTANT: This program does not include crisis support. If you are in crisis, please contact the Canada Crisis Number 1.833.456.4566/Text line 45645; https://www.crisisservicescanada.ca/en/
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