Project LETS
Cart
0
About
Programs
Trainings + Workshops
Chapters
Get Involved
Resources
Contact
Store
Donate
Back
Mission
Our Team
Impact
Press
The PMHA Model
Back
All Programs
Psychiatric Survivor Clinic
Providence Peer Support Grant
Healers-In-Residence
Anti-Carceral Peer Support Advocates
LETS Provider Collective (LPC)
Project LETS Conference
National Suicide Memorial
Day of Action
Community Crisis Response Maps
Justice4SaraDoe
Back
Trainings + Workshops
Political Education
Anti-Carceral Approaches to Suicide (Fall '23)
Back
Chapters
Our Chapters
Back
Opportunities
Community Research
Blog
Advocacy
Personal Narratives
Share Your Story
Back
All Resources
Crisis Support
Accessing Care + Healing
Your Rights
Incarceration & Homelessness
Mental Illness Experiences
Disability Justice
Race and Mental Health
Gender Basics
What is mental health?
Videos
Cart
0
About
Mission
Our Team
Impact
Press
The PMHA Model
Programs
All Programs
Psychiatric Survivor Clinic
Providence Peer Support Grant
Healers-In-Residence
Anti-Carceral Peer Support Advocates
LETS Provider Collective (LPC)
Project LETS Conference
National Suicide Memorial
Day of Action
Community Crisis Response Maps
Justice4SaraDoe
Trainings + Workshops
Trainings + Workshops
Political Education
Anti-Carceral Approaches to Suicide (Fall '23)
Chapters
Chapters
Our Chapters
Get Involved
Opportunities
Community Research
Blog
Advocacy
Personal Narratives
Share Your Story
Resources
All Resources
Crisis Support
Accessing Care + Healing
Your Rights
Incarceration & Homelessness
Mental Illness Experiences
Disability Justice
Race and Mental Health
Gender Basics
What is mental health?
Videos
Contact
Store
Project LETS
Donate
Request a PMHA (Form)
Name
*
First Name
Last Name
Pronouns
Email Address
*
Which categories most accurately represent your race/ethnicity?
*
White
Black or African American
East Asian
South Asian
Native Hawaiian or Pacific Islander
American Indian or Alaska Native (Indigenous)
Hispanic/Latinx
Which choice best describes your gender?
Cis man
Cis woman
Trans man
Trans woman
Non-binary
Genderqueer
Are you requesting a specific PMHA?
What is your main, presenting issue? What are you struggling with most?
*
What aspects of your identity are important to you?
*
What kinds of support do you have right now (if any)? Who are you comfortable talking to?
*
What goals do you have for working with a PMHA? Where do you need the most support?
*
Do you have any questions for us, or your PMHA?
Thank you!