I would like to be matched with a Wellness Buddy
Your privacy is important to us. All information provided will be kept strictly confidential and used only for the buddy matching process. We will process your application and get back to you within a week.
Full Name:
*
Gender:
*
Male
Female
Prefer not to say
Phone Number:
*
Please enter a valid phone number.
Format: (65) 0000-0000.
Email Address:
*
example@example.com
Age Range:
*
21-30
31-40
41-50
51-60
60+
Years in Legal Practice:
*
Junior Category Practitioner
Middle Category Practitioner
Senior Category Practitioner
Other
Length of Volunteering Experience with PBSG:
*
Less than 1 year
1-3 years
3-5 years
More than 5 years
NA
Areas where you would like support:
*
Work-life balance
Managing emotional impact of cases
Setting boundaries
Stress management
Burnout prevention
Professional development
General listening and sharing
Others
Please refer to this
link
for the list of buddies.
Preferred choice of Buddy (You may indicate more than one, if you have no preference, please indicate this):
*
Dixon Soh
Francis Xavier, SC
Linda Heng
Luo Ling Ling
Nicholas Aw
Peggy Yee
No preference
Consent and Acknowledgement
I acknowledge that the Wellness Buddies Programme is intended solely to provide peer support, general guidance, and share helpful resources. It is not a substitute for professional medical, psychological, or legal advice.
*
Yes
I understand that I will be matched with only one Buddy, and that any requests for rematching or changes will be considered on a case-by-case basis at the sole discretion of PBSG.
*
Yes
I agree to maintain strict confidentiality regarding all matters discussed during the matched session, and not to record, disclose, or share any personal or sensitive information exchanged.
*
Yes
I understand and accept that, should my Buddy feel there is a need for me to receive further support, he/she may recommend appropriate follow-up conversations and/or guidance.
*
Yes
I am aware that PBSG may follow-up or conduct check-ins, subject to my openness and availability.
*
Yes
I consent to PBSG’s collection, use and/or disclosure of the personal data and information submitted in this form for purposes related to the Wellness Buddies Programme, including but not limited to the administration of the programme and matching of buddies. I understand that I may withdraw my consent at any time by giving reasonable notice via email to DPO@probono.sg.
*
Yes
Submit
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