Gift From Within PTSD Resources for Survivors and Caregivers

We are a non profit organization. We would appreciate a donation of $5. Please send a check, money order, or use Pay Pal.

For Mental Health Professionals: If you are interested in finding a peer support pal also in the health profession please call Joyce @ 207-236-8858.

For Men: If you've experienced the following.....sexual assault, physical abuse, trauma from being robbed, beaten, REMEMBER....YOU ARE NOT ALONE....the following sites could be most helpful for you: For Men Only

All names are kept strictly confidential. GFW may contact you by email or phone.

At present, the Support Pal Network is not accepting people who are currently incarcerated and/or in psychiatric hospitals.

I understand that by signing this release form that:

• GIFT FROM WITHIN will assist me in finding an email support pal.
• GIFT FROM WITHIN will create a short biography based on my completed form that will be shared with members only.
• GIFT FROM WITHIN will keep my name, bio, and address confidential within the support pal network.
• GIFT FROM WITHIN will send me names and addresses after I return the questionnaire and complete a telephone screening with Joyce Boaz.
• GIFT FROM WITHIN may from time to time send me questionnaires that will be computerized and only used for scientific studies on PTSD. I hereby authorize the use of such questionnaires that I may sign for such purposes.

As a GFW Email Support Pal, I agree to the following:

1. All names will be kept confidential;
2. That I will not hold GFW or its Board Members responsible or liable in the event that the relationship does not work, no matter the reason. I understand there are no guarantees and some risk is involved.
3. I understand that a support pal could say something during our correspondence or communications that could be triggering and I need to be mindful of my own needs and limitations. I will also behave kindly and gentle towards others, remembering we are all in this together.
4. Note: GFW is not accepting snail mail only support pals at this time.

Please provide:
Personal History: name, age, gender, traumatic experience, why you want this service. (Some of this info will be shared with members only)

Please print: (or click here for printer friendly page)

Date_________________________________

Name____________________________________________________

Address_______________________________________________________________

City___________________________________ State________ 

Zip________________ Country ____________________

Why I want this service (include traumatic event) ____________________________________

_______________________________________________________________________________________


Occupation__________________________________________________________________


Hobbies and/or things that I enjoy___________________________________________


How did you find us?_________________________________________________________ 







"What People Are Saying About The GFW Support Pal Network"





Birthday_______________________

Language Preferences
(bilingual helpful)__________________________________


Phone______________________________________________  Email: ________________________

Best time to reach you_____________________________________________________

Your signature___________________________________________________________

Witness________________________________________________________________

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