EmailMeForm
NAMI Support Group Registration
Please complete the following form prior to joining your first virtual NAMI Support Group. You will only need to complete this form one time. Zoom login information will be provided to you the day of the meeting, at the provided email address.
Please note: Support groups are confidential and *NOT* open for observation
Name
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First
Last
Email
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Phone Number
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City of residence
Emergency Contact Name
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First
Last
Emergency Contact Phone Number
*
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Which *Virtual* group would you like to register for?
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NAMI Connection Support Group, Thursdays at 6:30 PM (for individuals with a mental health condition)
NAMI Family Support Group, First Monday of Each Month at 6:30 PM (for individuals who's loved ones live with a mental health condition)
How did you hear about NAMIGO Support Grouips?
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namigo.org
instagram
FaceBook
Other NAMI Program
Google
Medical Professional
Word of mouth
Warmline / Hotline
Other
If "Other" please explain
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Are you a service member or veteran?
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Please select
Yes
No
Do you live in and/or work in Osceola County?
*
Please select
Yes
No
Would you like to be added to our newsletter email list to receive information about our upcoming events, classes, and other programs we host throughout the year?
Yes
No
