Volunteer Provider Form


Thank you for considering volunteering your skills and time as a mental health clinician to assist people in need during the disruption posed by the COVID 19 crisis.


*Disclaimer: NAMI Maine is facilitating volunteer licensed mental health clinicians to connect with individuals desiring a supportive mental health check-in with a therapist for a one time, brief (15-30 minute) check-in.  NAMI Maine‚Äôs only role is to identify willing mental health clinicians and coordinate the connection of clinicians with individuals seeking support during the federal state of emergency. NAMI Maine is not liable for this service nor do we have any relationship, formal or informal, with the therapists volunteering their time or the individuals receiving this support. If therapists choose to continue supports with individuals beyond a one time check-in, NAMI Maine will not play a part in coordination of services.


Completion of this questionnaire will provide us with some information to facilitate a connection with someone in need.


Questions? Contact Natalie at Natalie@namimaine.org or (800) 464-5767 ext. 2305



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