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Specialist Intake Form

Thanks again for joining the onboarding session. To help us set up your 1:1 peer support sessions, please complete this short intake form.

Your responses will help us setup your profile and make it easy for members to find and book time with you.

What is your full name?

What is your ShareWell username?

This is the name you input when creating a free ShareWell account at https://sharewellnow.com

List up to 8 topics that represent the lived experiences you feel called to support.

 Recovery · Chronic Stress · ADHD · Divorce

If you've been through it, and feel able to support around it, please list it as a core topic

List up to 6 credentials, certifications, or formal training that support your role as a Peer Specialist.

 CRPS · Peer Recovery Specialist · Nutritionist · Navy Vet

Website Link (if you have one)

LinkedIn Profile

Instagram Handle

When are you generally available for 1:1 sessions in a typical week?

Before 9AM
9-11 AM
11-1 PM
1-3 PM
3-5 PM
7-9 PM
After 9 PM
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Which timezone are you on?

Anything else you'd like us to know?