Peer Support Training for Diabetes – Coast Mental Health

Sent on behalf of Coast Mental Health:

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Coast’s New Healthy Lifestyles and Diabetes Peer Program
We are accepting applications from trained Peer Support Workers ( must have a minimum of 1 year PSW experience ) who are interested becoming Healthy Lifestyles trained.
This program will be between 7 & 12 months in length and will include Healthy Lifestyles and Diabetes (Workshops by RN’s)  in-class training followed by the trained PSW’s co-facilitating  training / support groups in  Coast sites.
The focus of this new program will be:
HealthyLifestyle Promotion.

Please fill out the attached application form and submit to:
John Massam
1225 Seymour St.
Vancouver, BC  V6B 3N6
Fax: 604-683-3750
johnm@coastmentalhealth.com

If you are interested and want to know more, please call: 604-762-7925
Applications must be received by:  November 14, 2013

PSW Diabetes Support Program application
( please print clearly )
Please Note: attach (STAPLE) a reference letter from a professional indicating how this program will help with your long term employment / career goals.

Name: ________________________________________________________________________

Address: ______________________________________________________________________

_____________________________________________________________________________

Phone: ________________________ E-mail address___________________________________

1. I am:
___  Diagnosed Diabetic
___  Diagnosed Pre-Diabetic
___  Not diagnosed but am interested due to having some of the risk factors.
___ Have no risk factors but want the training for professional reasons.

2. I have received treatment for diabetes for: (please check one)
6 months____
1 year ____
2 years ____
3 or more years ____

3. I am a PSW Graduate: (please check one)
Coast ____
VCH ____
FHA ____

4. I have worked as a PSW for: (please check one)
1 year ____
2 years ____
3 or more years ____

5. I have demonstrated leadership and group facilitation skills by my involvement in the following activities: _______________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6. I am proficient at both e-mail and internet exploration: (please check one)
Yes ____ No ____ Somewhat ____

7.  Personally  I am interested in this program because: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

8. Professionally I am interested in this program because: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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