Please note that the service is intended for adults.
How did you hear about Relief and the individual support service? Who or what referred you here to complete this form?
Have you ever attended a self-management workshop with Relief or a Relief partner?
If so, which workshop(s)? Tick the workshop(s) you have attended.
What mental health issue(s) do you live with?
What are your expectations for the first session?
Please indicate your preferred session format
I understand that the one-hour theme-focused sessions with the mental health worker will be held every two weeks.
If you have chosen a virtual session, can you confirm that you have a computer, a webcam, a microphone and the Zoom app [free]?
I acknowledge that all virtual meetings take place with cameras on and that I am comfortable with technology.
I understand that the in-person sessions will be held in Montreal at 418 Sherbrooke St. East.
I confirm that I have read the terms and conditions of the service.
By checking the box, you consent – and understand that you can withdraw this consent at any time – to Relief collecting, using, disclosing, and processing your personal information for the following purposes:
· To confirm your identity, verify the accuracy of your personal information, and update it;
· To communicate with you, respond to your questions or requests, or address your complaints;
· To comply with legal and regulatory obligations;
· To update your member/client/donor file;
· To register you for one of our services;
· To grant you access to our platforms;
· To process payment for a service or donation;
· To issue and send receipts to you.
For more information about your rights and our personal information protection practices, we invite you to consult Relief’s Privacy Notice available here.