Support Intake

Your information

Pronouns
If you prefer to be contacted by phone, please provide us with the best number to reach you.
Preferred method of contact *

Peer supporter matching

We will do our utmost to match you with the best peer supporter for your stated preferences but cannot guarantee that all preferences can be accommodated.

If you have a preferred peer supporter you'd like to be matched with, please select their name.
If you have a preference for the type of peer supporter you'd like to be matched with, such as a journalist of colour, a woman journalist, a journalist who works in a one-person newsroom, etc, please enter those preferences here.

Request for support information

Please keep your responses brief and avoid sharing sensitive personal details. More information can be discussed confidentially with your peer supporter.

Program use acknowledgement

By submitting this form, you acknowledge and understand that the CNIPS program provides peer support, not professional mental health care. If urgent or specialized support is needed, CNIPS staff and peer supporters may encourage referral to appropriate professional resources.

Acknowledgment *