SUPPORT GROUP FACILITATOR APPLICATION

First Name

Last Name

Email

Phone

(###)

###

####

State in which you reside

Have you attended a Project NICU Virtual Support Group?

What is the month & year of your last NICU experience?

This is your childs last day in the NICU

Please tell us about your NICU experience including any area which may be helpful for us when scheduling you with support groups?

(Micro preemie, IVF, bedrest parent, full term NICU parent, 2nd/3rd time NICU parent, multiples parent, adoption of a NICU baby, breastfeeding challenges, being discharged on oxygen, trach experience ect.) Any and ALL details are welcomed here, and please share with us what you would be comfortable sharing with parents.

How much time can you commit to being a facilitator?

(Example: 1 support group/month, 1 support group every 2 months)

Tell us why you'd like to be a parent facilitator, and why you think you'd be a good support for NICU families?

Would you like information on becoming a Parent Mentor?

CONTACT US

CONTACT@PROJECTNICU.COM