NAMI KS -Partner and Spouses - Family Support Group

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This support group will be held every 2nd and 4th Tuesday of the month from 7:00 p.m. to 8:30 p.m. This is an online meeting held on Zoom. You will be sent the Zoom line after completing the registration form.

NAMI KS Support Group for Partner and Spouses is a peer-led support group for spouses, domestic partners, and significant others (18 years or older) of a loved one who is living with a mental illness. This support group is facilitated by NAMI-trained family member volunteers who know what it's like to have a partner or spouse struggling with a mental health condition or conditions.

First Name
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Last Name
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Email address
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Phone number ___-___-____
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Address-Street, City, State, Zip
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Emergency Contact -Name, phone, email

(Other than yourself)

Are you at least 18 years of age?
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Yes

Is your loved one with a mental health condition or symptoms?
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Spouse

Partner

Significant other

Has your spouse or significant other been diagnosed with a mental illness or have symptoms of a mental illness?
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Yes

If yes, what is their diagnosis? (Please select all that may apply.)
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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 helath condition and substance abuse)

Does not have an official disgnosis

Required

Is your loved one with a mental health condition an active duty service member or veteran? (this information is not reported to any outside organizations.)
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Yes

Were you referred to this support group through an outside agency?
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Yes

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

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

I understand that this support group is for Partner and Spouses only.
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Yes, I understand

No, (If no, please see following question )

Required

NOTE: If you need a support group other than for a spouse/partner with a mental health condition, please contact Nancy Moser at nancy.namifamily@gmail.com to be directed to an appropriate support group. I prefer:

A virtual online support group

An inperson support group

Other:

Clear selection

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

How did you learn about this support group?
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Friend or family

Social Media

Mental Health Provider

Pastor or church

Advertising

Support Group

Other NAMI Program

If you have any questions, please contact Nancy Moser at nancy.namifamily@gmail.com or Louise McIntire at elmcintire72@gmail.com
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