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Contact Us

We are looking forward to getting to know you. Please reach out using the email below, or if you are interested in participating in the MFY program, please fill out the form.

Email

query@mscft.com

Pre-registration Form

This form gives us information on the teen / participant, and their parent or guardian. We need this in order to begin the process of connecting you to our program. Please understand that we treat all information provided as confidential, and do not share anything outside the staff of this program.

If you are uncomfortable providing this information in the form, please send an email to query@mscft.com with your contact information and we will reach out to gather the remaining information that way.

Participant's Name *

First

Last

Pronoun *

Please let us know how you like to be addressed: e.g. he, she.

Participant's Email *

Please provide an email address so we can contact you. We will only use this address to communicate regarding the workshop. We will never sell your contact information or use it for any other purpose.

Phone number *

Please provide a number at which we can reach you.

Your age *

13 to 14
15 to 16
17 to 18
18+

Please indicate your age.

Parent / Guardian Name *

First

Last

Parent / Guardian Email *

Parent / Guardian Phone Number *

Is the participant / teen under the care of, or has been under the care of a mental health provider? *

Yes
No
Planning to work with one

Has the participant / teen been hospitalized for a mental health condition? *

Your answer to this question does not affect your eligibility to participate in the program.

Informational Meeting *

September 12th, 3:00 to 4:00pm PST
September 16th, 6:00 to 7:00pm PST

Please indicate which of these dates is your preference for an online informational meeting in which we will explain the program and answer your questions.

Additional information

Please share anything you'd like the facilitators to know, so that we can best serve the needs of participants in the program.

How did you learn about the program? *

CMSC website
Internet search
Referral from a teen
Referral from a parent
Referral from a friend
Referral from a healthcare professional
Other

Thank you so much for your interest and taking the time to fill out this interest form. Marina or Alex will be in touch.