Join our peer support community.

Name *

First Name

Last Name

Phone

(###)

###

####

Birthdate *

MM

DD

YYYY

What program are you interested in?

One on One Call

Peer Support

Case Support

Have you worked with us before?

Yes

No

Have you reported the incident(s)

Yes

No

I am considering it

If yes, who have you reported to?

Police

Civil Case

Office of the Sport Integrity Commissioner

National/Provincial Sport Org. or Club

Other

Are you under any publication ban, non-disclosure agreement, or confidentiality terms?

Yes

No

By clicking the box below, you acknowledge that you understand our peer support programs are not therapy and not a replacement for mental health services. *

I understand