Peer to Peer Support Volunteer

Pease tell us a little about your medical background, diagnosis or your connection to nutrition support:*
Starting ENStarting PNAdjusting to life with a Feeding TubeAdjusting to life with a central venous access deviceLiving independentlyParenting a child on nutrition supportEmotional/Mental HealthTraveling with medical needsInsurance / coverageNavigating school or workRelationships and family dynamicsNutrition and meal planningManaging day-to-day life with medical devicesOther
What are your hobbies or interest? *
Is there anything else you would like us to know when matching you with someone?*
EmailTextPhone CallZoom or Video callNo preference
Age groupDiagnosisType of Therapy (EN/PN)GenderCaregiverTreatment type (e.g., TPN, ostomy, feeding tube)Life stage (student, working, retired, etc.)Geographic location or regionNo preferenceOther
Why do you want to connect with a peer and offer support? *
What skills, strengths or experiences do you have that could help a peer on nutrition support?*
Why do you feel prepared to offer peer support to someone in the community?*
Oley peer-to-peer agreements
Agreement
By joining, you agree to:
- Use peer support for encouragement, not treatment.
- Maintain confidentiality and respect others' boundaries.
- Avoid giving medical advice or pressuring others to share.
- Keep the space safe, inclusive, and supportive for everyone involved.
Acknowledgment and Signature
I have read and understood the Oley Peer-to-Peer Support Agreement. By submitting this form, I agree to uphold the responsibilities outlined above and participate in a respectful and supportive manner.
Signature *

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We'll do our best to match you with someone who shares your experience and can offer support, insight, or just a friendly chat. Expect to hear back within 48-72 hours.
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Peer to Peer Support Volunteer Form

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