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.
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I understand that eFriend is NOT a crisis, counselling or mental health treatment service.
Your Details
Name
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First
Last
Email Adress
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General Wellbeing
Is eFriend right for you?
1.Are you feeling down, stressed, lonely, isolated or worried?
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Yes
No
2.Are you currently experiencing, or have you experienced over the past 2 weeks, significant trauma?
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Yes
No
3.Are you currently experiencing, or have you experienced over the past 2 weeks, thoughts of suicide?
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Yes
No
Have you previously raised concerns with anyone about your wellbeing?
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Yes
No
Have you previously accessed Mental Health Services?
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Yes
No
Are you currently accessing Mental Health Services?
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Yes
No
Do you have a mental health diagnosis?
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Yes
No
If yes, please specify
What are your current support networks? (Please tick all that apply)
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Family
Friends
Mental Health Service/s
Community group/program
Other (please specify)
Other (please specify)
How can eFriend support you? (Please tick all that apply)
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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
Other (please specify)
Other (please specify)
Is there any other information you’d like to provide that may be relevant?
