MHLEPQ

Membership Form

Ready to be part of the change?

Become a Lived Experience Member or Friend of the Peak By signing up you will receive updates about how to get involved! We want to connect with you To make sure we send you the right information and opportunities, this form will ask some questions about you. Questions with an asterisks* beside them require a response. If you are having any issues completing the form, or have some questions, you reach us directly via email at: [email protected]. Your privacy is important to us. Please read our Privacy Policy for details on how we protect

Do you live in Queensland?(Required)

Thanks for connecting with us!

To receive updates from the MHLEPQ, we need a few details from you.
Name(Required)
Select one of the statements below that best describes you(Required)

Thanks for being a Friend of the Peak

So we can keep you in the loop - we need a few details from you
Name(Required)
Are you a sector professional?(Required)
is mental health related to the work you do in your position or within you industry

Anything else you would like to share?

Feel free to add any information you would like to share with us

Professional Information

*if there is something we have missed or you want to share with us, you can let us know later in the
Select any regions that your organisation delivers services within?
you can choose multiple options
Select the service type best describes the organisation you work for?(Required)
you can only select one *if there is something we have missed or you want to share with us, you can let us know later in the form*
Are there any lived experience roles or functions within your organisation?
Roles could be paid or voluntary positions. For example: peer support workers, committees and advisory councils, or peer groups ect.
Which of the below best describes the leadership level within your role?
Feel free to add any information you would like to share with us

Work in the sector - Professional Information

*if there is something we have missed or you want to share with us, you can let us know later in the
Select any regions that your organisation delivers services within?
you can choose multiple options
Select the service type best describes the organisation you work for?(Required)
you can only select one *if there is something we have missed or you want to share with us, you can let us know later in the form*
Is there any lived experience roles or functions within your organisation?
Roles could be paid or voluntary positions. For example: peer support workers, committees and advisory councils, or peer groups ect.

Welcome to the MHLEPQ community! Let's help build a mental health system we deserve!

So we can connect with you, work with you, learn from you and share opportunities you may be interested in - we need to know a little more about you. *if there is something we have missed or you want to share with us, you can let us know later in the
Name(Required)
Your Pronoun?
*if there is something we have missed or you want to share with us, you can let us know later in the form*
Select your age group
Do you identify as any of the below?
*if there is something we have missed or you want to share with us, you can let us know later in the form*
Are you professional in the sector?(Required)
in a job or industry related to mental health, like a peer support worker, or work in the community services field

Advocacy and Activism

*if there is something we have missed or you want to share with us, you can let us know later in the
Have you been involved with advocacy or activism before?
This could be a time you spoke up for change, equality, Rights, or issues that are important to you. For example: advisory council membership, public speaking, community group, campaigning, or attending a protest.
Have you ever been part of a Board or Committee?
this could be an advisory council, project board, or steering committee
in your words: you can add details about your involvement, experiences, role or ant other information you would like to share with us.
Do you have personal lived experiences, or are any of the below, important topics you want to advocate for?
*if there is something we have missed or you want to share with us, you can let us know later in the form*
you can list any advocacy areas that are important to you

Almost there!

We are looking forward to connecting with you Our Values of Safety, Respect ,Intention, Integrity and Outcomes are our Community's agreement of what is important to us and makes sure we look out for each other.
Do you agree to act with the Values of our Community at heart?
Our Values are our commitment to each other and guide all our actions, interactions and decisions. You can find more information about our Values, why they are important, and our Value commitments on our website: www.mhlepq.org.au
in your words: space to share your ideas, vision or wish for the future, any feedback for us, or anything else important to you

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Would you like to get involved?

Name(Required)
Do you have a direct experience of mental illness?
Do you identify as having a direct personal experience of suicidal ideation or surviving a suicide attempt?
Would you like to receive updates and news from the MHLEPQ?
Would you like a callback form the MHLEPQ?
Please note MHLEPQ is not a crisis support service. If you need crisis support please contact Lifeline.
This field is for validation purposes and should be left unchanged.

No, thank you.