Online NAMI Connection Recovery Support Group Registration Form Online NAMI Connection Recovery Support Group Registration Please fill out the form below to register for Connection Recovery Support Group. (*Asterisk indicates a required field) Select a Connection Support Group session date*Tuesday, November 3, 2020 at 6:30 pmThursday, November 19, 2020 at 6:30 pmName* First Last Phone Number*Email Address Please indicate your preferred method of contact Phone Email Text Veteran, Active Duty or Related?Is this your first time to this online support group meeting?YesNoEmergency Contact InformationTo protect our meeting participants, we ask all participants to provide us with an emergency contact person that we could contact ONLY in the event of an emergency. This information is kept completely confidential - it will never be sold or shared.Emergency Contact Name* First Last Emergency Contact Phone*Emergency Contact Email Acknowledgments*Please select all four. I acknowledge that I am an adult, 18 years of age or older, with a mental health condition * I acknowledge that as a participant of this group, I must abide by NAMI's policy of confidentiality and therefore am prohibited from taking and screenshots, pictures, recordings, sharing of material, ect. * I acknowledge that what is discussed in our support group remains confidential unless someone is a danger to self or others. * I acknowledge that this is a support group and that information and insight I receive do not represent therapeutic representations of a healthcare professional.