Book a call with one of our experienced eFriend Peer Support Workers!

You are not alone and our team are here to listen, empower and provide hope. Take a positive step in your recovery towards a better and brighter future by completing this short questionnaire now to ensure that we can meet your needs.

This will take a maximum of 3 minutes.

Is eFriend right for you?
I understand that eFriend is a virtual peer support service and offers befriending sessions to connect with people feeling down, stressed, lonely, isolated or worried. I understand that eFriend is NOT a crisis service.*
- I understand that eFriend is NOT a crisis, counselling or mental health treatment service.

Your Details
Name*
First Last
Email Adress*
Are you currently living in Australia?*

General Wellbeing
Is eFriend right for you?
Are you currently experiencing loneliness, despair, depression, lack of connection to others?*
- Yes
- No
Are you currently experiencing, or have you experienced over the past 12 months distressing events in your life?*
- Yes
- No
If so, are these events due to : Abuse/violence in relationships, ongoing Post Traumatic Stress Disorder, assault/rape?*
- Yes
- No
Have you experienced over the past 4 weeks, frequent and intense thoughts that suicide is an option for you that you are considering?*
- Yes
- No
Have you previously raised concerns with anyone about your wellbeing?*
- Yes
- No
Have you previously accessed Mental Health Services?*
- Yes
- No
Are you currently accessing Mental Health Services?*
- Yes
- No
Do you have a mental health diagnosis?*
- Yes
- No
If yes, please specify
What are your current support networks? (Please tick all that apply)*
- Family
- Friends
- Mental Health Service/s
- Community group/program
- None
- Other (please specify)
Other (please specify)
How can eFriend support you? (Please tick all that apply)*
- Feel less lonely
- Refer me to resources/services that can help me
- Offer the chance to talk to someone who understands
- Learn strategies for improving my mental health
- To talk about COVID
- Other (please specify)
Other (please specify)
Is there any other information you’d like to provide that may be relevant?

© Independent Community Living Australia | Website developed with ❤️ by Katberg Digital

© Independent Community Living Australia

Website developed with ❤️ by Katberg Digital

Independent Community Living Australia eFriend Service is supported by funding from the Australian Government.

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