APSU Member Signup - Sharc APSU

First name

Last name

Email

Mobile

Year of birth

1. How would you describe your relationship with alcohol and other drug, and/or mental health services?

(Please select all that apply)

I am a current or past consumer of AOD services

I am a current or past consumer of mental health and wellbeing services

I am a family member / partner / supporter

I work or volunteer in an AOD, mental health and wellbeing, or allied service

2. What year did you last use an AOD service?

3. What year did you last use a mental health service?

4. What year did the person you support last use an AOD or mental health service?

5. What year did you last work or volunteer in an AOD, mental health and wellbeing, or allied service?

6. How would you describe your lived or living experience?

(Please select all that apply.)

Lived or living experience of alcohol and / or drug use (AOD)

Lived or living experience of mental health concerns

Lived or living experience of problems with gambling

None of the above

7. Gender Identity

8. Self Specify

9. Do you identify as LGBTIQA+?

10. Do you identify as Aboriginal and/or Torres Strait Islander? (Please select all that apply)

Yes Aboriginal

Yes Torres Strait Islander

No

11. Are you part of a culturally and linguistically diverse family/community?

12. Do you speak a language other than English with your family and friends?

13. Please specify what language/s you speak with your family and friends

14. Do you have a lived experience of disability?

Yes

No

15. Please select all options that apply to you:

visible or invisible

sensory or physical

neurodiverse

cognitive

intellectual or developmental

prefer not to say

16. Where are you located?

17. What is your postcode?

18. Would you like to receive a copy of Flipside magazine?

Flipside is a publication by and for consumers. APSU members can contribute their articles, stories, poetry, artwork, or designs. (Select your preference)

Yes, electronic copy

Yes, hard copy

No, I don’t want to receive Flipside

19. Would you like to receive emails about:

(Please select all that apply)

Consumer and family participation, and consultancy activities. 

Receive invitations to participate in paid opportunities including focus groups, consumer advisory groups and co-design workshops.

Training sessions for consumer and family participation.

Find out more about training to support consumer and family participation, and when the next sessions are being held.

Speaker Bureau.

Help raise awareness, overcome stigma and shame, and educate people about drug use, recovery and hope by telling your story. Join to find out about speaker training and upcoming speaker events.

Issues and information relating to AOD services and policy.

Stay up to date and receive regular emails about AOD services and policy, drug alerts, employment opportunities and other updates about the AOD community.

20. Tell us why you want to join APSU

21. Privacy and Confidentiality Statement - Required

To read the full statement click here

All personal details obtained by APSU will be kept confidential and only used for the purposes outlined above.