We Can Help – Families for Addiction Recovery

First Name*

Last Name

City*

Province*

Postal Code*

Email*

Phone*

I would like to provide additional information to allow FAR to match me with the most appropriate volunteer supporter

Yours Child First Name

Child's Age

Please enter a value between 0 and 100.

Child's Gender

Other Household Residents:

Do you have a Spouse/Partner?

Other Children

What is the nature of your child’s addiction? For example: alcohol, marijuana, prescription drugs, heroin, meth amphetamine or other?

Has your child been diagnosed with a mental health condition by a doctor?

What is the diagnosis?

Is your child LGBTQ+?

Is there anything else you would like us to know in order to match you with a parent supporter?

P2P will assign a person with lived experience as the parent of a child with an addiction as a temporary support to me and I understand that the Parent Supporter is not a professional. The purpose of the Parent Supporter is to:
- listen to my experience, and let me know that I am not alone and that there is hope.
- point me to resources to educate myself about addiction.
- discuss coping skills and setting boundaries.
- talk about how to communicate with and relate to a child in active addiction.
P2P offers 8 conversations of up to one hour each with the Parent Supporter over a two month period unless mutually agreed otherwise. Meetings will be by phone, and scheduled at times decided between me and my Parent Supporter.
The program is not a substitute for professional counselling, therapy, or mental health care. Parent Supporters cannot provide advice on what to do in a specific situation.
I consent to FAR’s collection and use of my personal information for the purposes described above. I understand that FAR will not share this information with any other organization or third party in accordance with its privacy policy.
I release and indemnify FAR and its directors, officers and volunteers from and against any loss, damage, claim or liability to me or any other party arising from my participation in P2P.

I am at least eighteen (18) years of age and I have read and fully understand this Acknowledgement, Release and Indemnity and agree to its terms.

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