AAJA Mental Health Funding Request
Filling out this form is the first step to securing funding to pay for mental health services. Once you've completed this form, someone from AAJA will reach out to you to discuss next steps. Due to limited funding and resources, AAJA is prioritizing the most pressing cases and applicants who have identified a mental healthcare provider. Also, at this time, funding is only being given to journalists who are AAPI. Applying for funding does not guarantee you will be granted money.
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Full Name *
Email Address *
Phone Number *
Are you an AAJA member? *
City *
State or Territory *
Link to portfolio, LinkedIn profile or collection of work. *
What is your current employment status? *
What mental health services and benefits do your current employer and/or health insurance provider offer? How much have you taken advantage of these services and benefits? *
How much financial assistance are you seeking? (The maximum is $1500) *
What is the minimum amount you need? *
Do you currently have a therapy provider? *
If you answered yes to the question above, how much do you have to pay out of pocket for each visit?
Are you Asian, Asian American and/or Pacific Islander? *
Anything else we should know? Please include any relevant information about your situation that you feel comfortable sharing.
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此表单是在 Asian American Journalist Association 内部创建的。 举报滥用行为