Registration This will take a maximum of 3 minutes. Step 1 of 2 50% Consent FormDo you consent for our team to contact you if we need more information to determine if this service is suitable for you: Yes No Unfortunately, we will not be able to progress with your referral without you consenting to being contacted. We encourage you to consider re-referring yourself if you are able to provide this consent in future.Do you consent for minimal information to be collected and stored by ICLA so we can determine if this service is suitable for you:(Required) Yes No Unfortunately, we will not be able to progress with your referral without you consenting for your information to be collected and stored. We encourage you to consider re-referring yourself if you are able to provide this consent in future.Applicant DetailsYour name(Required) First Last Your contact number(Required) Your email address (will be your username)(Required) Password Enter Password Confirm Password What is your preferred method of contact?(Required) Phone call Email Please specify Post code(Required)Please enter a number from 999 to 10000.I understand that eFriend is a service and offers virtual peer support sessions to connect with people feeling down, stressed, lonely, isolated or worried. I understand that eFriend is NOT a crisis, counselling or mental health treatment service.(Required) Yes No Unfortunately, we will not be able to progress with your referral without you confirming that you understand the above that eFriend is NOT a crisis, counselling or mental health treatment service.I have downloaded and read the eFriend Agreement and I agree to its terms and conditions.(Required) Click here to download eFriend Agreement Yes No Unfortunately, we will not be able to progress with your referral without you agreeing to the terms and conditions. Are you currently living in Australia?(Required) Yes No Unfortunately, we will not be able to progress with your referral. You need to live in Australia to access this program. Are you 18 years old or over?(Required) Yes No Unfortunately, we will not be able to progress with your referral. You need to be 18 years or over to access this program. Are you currently experiencing loneliness, despair, depression, lack of connection to others?(Required) Yes No DemographicsDate of Birth(Required) DD slash MM slash YYYY What gender, if any, do you identify with?(Required) Female Male Gender diverse Agender Gender not listed Prefer not to say What are your preferred pronouns?(Required) She/her He/him They/them Other Prefer not to say Please specify: Do you identify as part of the LGBTQI+ community?(Required) No Yes Prefer not to say Do you identify as indigenous? Aboriginal Torres Strait Islander Both Aboriginal and Torres Strait Islander Neither Indigenous Identity not listed Prefer not to say Do you identify as culturally and/or linguistically diverse? i.e. do you speak a language other than English at home, or were you born in a country other than Australia?(Required) No Yes Prefer not to say Please provide details if you would like to: Do you identify with any mental health diagnoses?(Required) No Yes Please provide details if you would like to: Do you consider yourself to have a disability?(Required) No Yes Prefer not to say Please provide details if you would like to: Screening QuestionsHow can eFriend support you? (Please tick all that apply)(Required) 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: HiddenWhat are your current support networks? (Please tick all that apply) Family Friends Mental Health Service(s) Community group/program None Other What are your current support networks? (Please tick all that apply)(Required) Family Mindspot Friends Mental Health Service(s) Community group/program None Other Please specify: What supports have you accessed in the past? (Please tick all that apply)(Required) Family Friends Mental Health Service(s) Community group/program None Other Please specify: Have you ever, either currently or in the past, had experiences that have left you with trauma i.e a deep, long lasting emotional impact?(Required) No Yes If so, does this trauma currently cause significant disruptions to your mood, functioning or capacity to live a meaningful life?(Required) No Yes Are you currently experiencing issues relating to domestic and family violence, disordered eating, or addiction?(Required) No Yes Over the past 4 weeks, have you experienced frequent and intense thoughts of suicide?(Required) No Yes Is there any other information you’d like to provide that may be relevant?eFriend and Mindspot are undertaking research investigating the value of peer support services as an adjunct to clinical care - are you happy for your data to be included in a deidentified group summary of eFriend participants who are also linked with Mindspot? Yes No Are you happy to provide feedback about your experience of peer support while participating in MindSpot services? Yes No You can now proceed to booking a call. Please be patient waiting for the call booking screen to load, this may take a few seconds.