July/Aug 2024 NAMI KS Family to Family Online Class

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This ZOOM class will be held every Monday from July 8, 2024 to August 26, 2024 from 6:00 pm to 8:30 pm.

Please fill out one form for each person. You will be contacted with the Zoom link after completing the registration.

NAMI F2F is a free, 8 session educational program for family, significant others and friends of people with mental health conditions. NAMI F2F is taught by NAMI-trained family members who have been there, and includes presentations, discussions and interactive exercises.

Email Address *

First Name *

Last Name
*

Phone Number *

Complete mailing address (please include city, state, and zip code so that we can mail you the participant manual) *

Emergency Contact Name, Phone, Email

(other than yourself)

Are you a spouse, partner, sibling, parent, significant other, teen or adult child, or friend of an adult (aged 16 or older) living with a mental health condition or the symptoms of a mental health condition (even if not officially diagnosed)? *

Yes

Are you an adult over the age of 18? *

Yes

If your loved one is a child, are they between the ages of 13-22?

Yes

Clear selection

If no, to the above question, are you between ages 14-18 AND attending as a participant with an accompanying parent or guardian?

Yes

Clear selection

If you answered yes to the above question, who is your parent or guardian you are attending with (please state their full name)?

What is your loved one living with a mental health condition or showing symptoms of a mental health condition's relationship to you? *

My spouse or partner

My parent or guardian

My grandparent

My child

My grandchild

Myself

Other:

Has your loved one received a diagnosis from a qualified mental health professional? *

Yes

No (This does not necessarily disqualify you from attending this course.)

If yes, what is their diagnosis? (Please select all that may apply.) *

Anxiety Disorder

Bipolar Disorder

Borderline Personality Disorder (BPD)

Depressive Disorder

Obsessive-Compulsive Disorder (OCD)

Post-Traumatic Stress Disorder (PTSD)

Experiences Psychosis (such as hallucinations or delusions)

Schizophrenia

Dual Diagnosis (both a mental health condition and substance misuse)

Does not have an official diagnosis (please share symptoms in the "other" option)

Other:

Required

Is your loved one with a mental health condition or experiencing symptoms of a mental health condition a military service member or veteran? *

Yes

Are you a military service member or veteran? *

Yes

I understand that the information and insight provided by group leaders and participants does not represent therapeutic recommendations and is not meant to be a substitute for the advice provided by a mental health provider or other health care professional. *

Yes, I understand

I understand that some NAMI Kansas Staff and volunteers may be mandated reporters. If any participant exhibits behavior that may lead to harming themselves or others, the appropriate authorities will be notified immediately.
*

Yes, I understand

May NAMI Kansas use your email address to send you our newsletter with updates and upcoming events?
*

Yes

How did you learn about this course?
*

Friend or family

Social Media

Mental Health Provider

Pastor or church

Advertising

Support group

Other NAMI program

Other:

Have you participated in any of these NAMI Signature Programs?
*

NAMI Basics

NAMI Peer to Peer

NAMI Family Support Group

NAMI Connections Recovery Group

NAMI Homefront

None of the above

If you have any questions please contact (Nancy Moser, nancy.namifamily@gmail.com). This NAMI Family-to-Family class is hosted by NAMI Reno and NAMI SW KS.

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