Application for LEAP ® Training 2022
Do you have a family member with a serious mental illness and won’t acknowledge it, and isn’t willing to accept treatment? If so, then LEAP can help by improving and strengthening your relationship. This course is offered free-of-charge for family members in Alberta. If you're interested in a course for your workplace, please email Alberta.LEAP@gmail.com .
Which session would you like to attend?
*
Mondays May 2, 9 & 16
Notification list for future courses
Name
*
First Name
Last Name
Email
*
Confirmation Email
Phone Number
*
-
Area Code
Phone Number
Will your spouse or another family member be attending?
*
Yes
No
Spouse/Other Name
First Name
Last Name
Spouse/Other Email
example@example.com
Spouse/Other Phone Number
-
Area Code
Phone Number
What is the relationship of your loved one to you?
*
my son
my daughter
my parent
my niece or nephew
my sibling
my spouse
Other
Age of loved one
*
Name of your loved one (optional)
Diagnosis (If undiagnosed or unsure, please check "other" and describe the symptoms):
*
Schizophrenia
Schizoaffective Disorder
Bipolar Disorder
Borderline Personality Disorder
Other
How long have you been aware of your loved one's mental illness?
*
Less than 1 year
1 to 3 years
More than 3 years
Where did you hear about LEAP® ?
*
FAMI-Alberta newsletter
Access Open Minds
CMHA-Edmonton
Caregivers Alberta
Access 24/7 (Alberta Health Services)
Online search
Other
Is there any additional information you want to share?
Submit
Should be Empty: