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Youth Engagement
Your Name
Your Birthday
Full Address
Name(s) of Parent(s)
Your Email
Home Phone
Cell Phone
Do you prefer calls or texts?
—Please choose an option—
Phone Call
Text Message
What area do you live in?
Are you currently a Woodview client?
—Please choose an option—
Yes
No
If no, were you a Woodview client previously?
—Please choose an option—
Yes
No
What experience do you have with mental health services?
Why would you like to be a part of Woodview's Youth Engagement Group?
How do you see yourself contributing?
What are some of your strengths and weaknesses?
Are you available to meet in the early evenings?
—Please choose an option—
Yes
No
Are you able to commit to one evening every few weeks for a year?
—Please choose an option—
Yes
No
Do you feel comfortable speaking in front of a group of people?
—Please choose an option—
Yes
No
X