Caregiver Support Group Facilitator Intake Form

Caregiver Support Group Facilitator Intake Form
Thank you for your interest in becoming a caregiver support group facilitator with Family Caregivers of BC. This short form (10–15 minutes) helps us learn more about you and ensure the role is a good fit.
Basic Information
Full Name*
Geographic Location (City/Town & Region):*
Organization (if applicable):
Are you applying as a:*

Staff MemberVolunteerOther
If you are a volunteer, please share the name and email of your staff contact:*
If you are keen to volunteer with FCBC Support Groups, tick below:

Yes, I want to volunteer
About You
1. What inspired you to consider becoming a caregiver support group facilitator?*
2. Do you have any personal or professional experience with caregiving?*

YesNo
Who have you supported?*
Are you currently caregiving?*
How long have you been (or were you) in a caregiving role?*
⚠️ Note: In most cases, we do not recommend active caregivers take on a facilitation role due to the emotional and time demands involved.
3. Tell us a bit about your current life circumstances. (e.g., work, family, other commitments, general capacity)*
4. What types of self-care or wellbeing activities are part of your routine?*
5. Do you have any previous experience leading or facilitating groups?*

YesNo
If yes, please describe briefly*
6. What do you hope to gain or contribute by being a support group facilitator?*
7. How comfortable are you supporting others who are experiencing strong emotions (e.g., grief, frustration, guilt)? (Optional: Share an example of how you’ve supported someone emotionally.)*
8. How do you plan or prefer to facilitate groups?*

Virtual onlyIn-person onlyA mix of both
9. Do you have any questions or anything else you’d like us to know?
Should be Empty:

Caregiver Support Group Facilitator Intake Form

Basic Information

About You