Registration

Please select the theme of your workshop

I confirm that I have been diagnosed with bipolar disorders by a healthcare professional.The diagnosis of bipolarity by a health professional is required to participate to the Living with bipolarity workshop.

Please choose the type of workshop you wish to follow between the virtual or in-person formula

Please choose the specific workshop you will register for from the options below. Make your choice based on the time slot and start date of each option. Make sure the time and schedule suit you, taking into account that the workshop will end 10 to 13 weeks after the start date.

Are you currently being followed by a doctor ?

Are you currently followed by a mental health professional? [psychologist, psychotherapist, psychiatrist, social worker, sexologist, occupational therapist, psychoeducator]

Comments

If you have chosen a workshop given in virtual mode, can you confirm that you have a computer, a camera, a microphone and the Zoom application [free] in order to follow it?

I confirm that I am technologically comfortable using online tools, i.e. Zoom and the interactive platform where all the content of the workshop will be found.

I understand that all meetings are held with the camera open.

I understand that the self-management workshop in which I wish to participate is a group process. My active participation in the group is important throughout the process for my personal recovery journey, but also for mutual support within the group.

I understand that although the group is a strength and provides a safe environment, it is not group therapy or a support group. It will therefore not be possible to speak at length about my personal experience with the aim of finding solutions or venting.

I understand that the onsite Relief workshops are offered in Montreal - at 418 Sherbrooke Street East.

By checking this box, I consent to the collection and processing of my personal information in accordance with Quebec's Law 25. I understand that this information will be used solely for the purpose of the provided service and will not be shared with third parties without my explicit consent.

Payment

By completing and submitting this secure form with your payment information, you are consenting to the payment by credit card of the self-management workshop fee ($555 for all themes except bipolarity which costs $655).

Contact Information

First name

Last name

Phone

Billing information

Address (Line 2)

Adresse (Ligne 2)

City

Province

Required field for residents of Canada and the United States

Postal Code

Country

Payment Information

Name

Card number

Please enter the two digits corresponding to the month of your card's expiration date.

Please enter the two digits corresponding to the year of your card's expiration date.

CVV

The CVV/CVC code (Card Verification Value/Code) is located on the back of your credit/debit card on the right side of the white signature strip; it is always the last 3 digits in case of VISA and MasterCard. Please copy your CVV/CVC code from the back of your card and continue with your payment.

Card type

VisaMastercardVisa DebitMastercard Debit

Personal information

Registration

PaymentBy completing and submitting this secure form with your payment information, you are consenting to the payment by credit card of the self-management workshop fee ($555 for all themes except bipolarity which costs $655).

Payment

By completing and submitting this secure form with your payment information, you are consenting to the payment by credit card of the self-management workshop fee ($555 for all themes except bipolarity which costs $655).