Establish a Support Group

Date*

Group Name*

Contact Name*

Phone*

Mobile

Email

Define the key issue that group members will meet to discuss or share. (For example, is it a health condition, a disability, a social issue or a mental health concern? What are the specifics? Please provide as much information as possible).*

What would you like the group to offer its members? Tick the most appropriate areas.*

Mutual Support: Providing a safe environment for people to share experiences and lend support.
Educational: Inviting guest speakers, information sharing about the issue, developing ideas and coping strategies.
Advocacy/Lobby: Campaigning for change in the community.
Discussion: A discussion group to share ideas, views and experiences.
Social Interaction: Meeting together for companionship and sharing.
Recreational: Opportunity to gather with others and participate in recreational or leisure activities
Other (please specify)

Other (please specify)

What experience has brought you personally to consider starting and running a group?*

Who is likely to want to be involved in getting the group started? (This may include friends, professionals or other people you have met).*

Who will be eligible for membership of the group? It is important to think about criteria for membership so that the original purpose of the group is maintained. You might want to ask yourself: Is it a culture/gender/age exclusive group due to the nature of the concern? Can anyone who is interested join the group? Can someone’s partner/carer/friend/family join the group?*

What is the geographical area from which group members will be drawn? Is the group for local residents, metro, regional and rural or North, South?*

Do you have any people interested in attending the group already?*

5 to 10 people
10 to 20 people
Other

Other (please specify)

If there are people interested in attending, where have they been referred from or how did they hear about you?

What will be the group’s purpose or goal? Aims and objectives are a list of things the group wants to achieve. They provide guidelines and are a useful way of defining your group for prospective members, health professionals and service providers. Please provide as much information as possible.

Support Group Establishment Form

If you have any queries please contact the CDO Josephine on (08)9364 6909 or email Josephine@connectgroups.org.au