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EPI-CAL Lived Experience Integration Interest Form
Name
City and state in which you currently live
Email address at which we can contact you
Please select all that apply to you
I have lived or living experience with psychosis or something that could be labeled psychosis
I am a peer support specialist working with individuals with lived or living experience with psychosis or something that could be labeled psychosis
I have a loved one with lived or living experience with psychosis or something that could be labeled psychosis
None of the above applies to me
Which of the following are you interested in? (select all that apply)
I am interested in joining your online community
I am interested in joining the advisory council once it is established
I am interested in potential future consulting opportunities with your team if they become available
I have an idea for something not listed on which I would like to collaborate with the LEI team (please briefly describe)
Anything else you would like to add?
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