Recovery Academy working to meet your needs

Name: First & Last

Phone number Best to reach you at

Email Address Best to reach you at

Preferred Language to facilitate in

English
French
Other

When are you available?

What days of the week, what hours, and how often

Click to enter text

Are you willing to appear in videos? in recognition of stigma this is a personal choice

Yes
No

Payment of Honoraria which of the following methods are acceptable

Cash
Cheque
Email Transfer
Other

Topics I would like to facilitate

Supporting Well-being and Recovery
Coping with Crisis
Enhancing/Improving Communication between Family members
Navigating the Mental Health and Addictions system
Dealing with problems in caring
Substance misuse in the family
Other:

Future Interest what is your vision for your work with Recovery Academy?

Occasional
Part-Time
Full-Time
Other:

I would really like to co-create a course(s) on:

I am a trained/certified facilitator of the following: Please name the course and if you can charge a fee