BIASC Caregivers Peer Mentor Program Survey

BIASC Caregivers Peer Mentor Program Survey

BIASC is developing a caregiver peer mentorship program. A caregiver peer mentorship program is a program that is developed that includes one or more people of similar experience working together to help each other grow through support of being a caregiver. A peer is someone that has a shared experience. A mentor is someone that shares a similar experience and helps another person through support and by working together. Please complete this form and answer the questions to help with gathering information that is needed to develop this program.
1.Do you have a loved one with a brain injury?

(This is a requirement for the peer mentor program)(Required.)
2.After your loved one’s injury, do you think you would have benefitted from having a peer mentor?(Required.)
3.How would a peer mentor program have helped you at the beginning of your loved one’s brain injury?(Required.)
4.When BIASC starts a caregiver peer mentor program would you be interested in becoming a peer mentor?(Required.)
5.Do you have a suggestion for the peer mentorship program?(Required.)
6.(Optional) Provide your Name and Contact Information if you're interested in becoming a peer mentor: