Peer_Support_Specialist

Peer Support Specialist Screener

Name*

Date of Birth*

Date

Agency (if any)

YesNo

Offering and promoting recovery-based servicesAssisting individuals in recovery in obtaining services that suit each peer's individual recovery and healing needsAssisting individuals in recovery in developing empowerment skills through self-advocacyAssisting individuals in recovery in developing problem-solving skills SO they can respond to challenges in their recoveryWhen appropriate sharing your unique perspective on recovery from mental illness and co-occurring disorders with non-peer staffAssisting staff in a collaborative process in identifying programs and environments that are conducive to recovery

Please include the name and contact information for 3 references from individuals able to speak to your abilities as a peer specialist, using your recovery skills to support others. Letters should contain specific details and descriptions of your strengths, skills and abilities that will make you an effective peer specialist.

Please do not list your current supervisor, relatives, close friends, or current providers as references. Some ideas for who can be a reference: colleagues at your current job; former supervisors or co-workers; leaders or support people in your community who know your work in a volunteer capacity.

1*

2*

3*

Please provide a detailed explanation of your strengths skills and abilities that make you a strong candidate for this role In your response include specific examples of how your own recovery journey has equipped you to support others in their recovery process Share how your personal experiences have shaped your ability to empathize with others and provide effective support*