CRASH COURSE HITS 1000 - NAMI Contra Costa mail: [email protected] NAMI SPANISH...

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NAMI Contra Costa September 2017 1 Contra Costa’s Voice on Mental Illness July 2014 61714 1200P The NAMI Contra Costa Newsletter is available on the web at: www.namicontracosta.org You can get a copy of this newsletter and/or the electronic newsletter by e mailing: [email protected] Email: [email protected] Phone Number 24/7: (925) 465-3864 Office Number: (925) 942-0767 If Your Family Faces The Challenge of Mental Illness . . . E mail: [email protected] and/or crashcoursehelp@ aol.com September 21, 2017 GENERAL MEETING 7:00 - 9:00 p.m. Thursday, September 21, 2017 SPECIAL PRESENTATION Dr. Steven Seager Dr.Seager will Present his film “Shattered Families” The Collapse of America’s Mental Health System Dr. Seager is a psychiatrist, author and filmmaker. He will show his latest film “Shattered Families” which details the problems with the current mental health system. Dr. Seager, a former Emergency Room physician, has been a psychiatrist for 25 years specializing in the treatment of the mentally ill. Dr. Seager will be open to answering your questions. He currently works at the Contra Costa Regional Medical Center (County Hospital). Location: John Muir Hospital Concord Campus 2540 East Street Concord Open To The Public- Free Admission CRASH COURSE HITS 1000 As this NAMI Newsletter goes to press, the Crash Course has served over 1000 troubled fami- lies. Founded in February of 2016 by the Behavioral Health Ser- vices, Miller Wellness, Family Jus- tice Center and the managing part- ner, NAMI Contra Costa, it has been offered every Wednesday evening at the Family Justice Center in downtown Concord. The Crash Course has fea- tured a compre- hensive orienta- tion to the men- tal health field in Contra Costa County. It of- fers an introduc- tion to and de- tails about the services a fami- ly would need to manage a psy- chiatric case. The lead author of the ma- terial was Kimberly Krisch of the Miller Wellness Center. (Continued on page 4) Kimberly Krisch Miller Wellness Center NAMI IN MOTION COMMUNITY EVENT & FUNDRAISER Let the good times roll. Join the NAMI in Motion stroll, Saturday, October 7, 9 AM to noon, Pleasant Hill Park, 147 Gregory Lane. Fun for kids and the young at heart, your pets, too, but on a leash, please. Free face painting, cupcake decorating, bounce house, and bubbles floating playfully in the air. Grab some free fruit and water and listen to live music by the Herb Putnam Clubhouse musi- cians. Anticipate a number of raffle prizes, including male and female Fit Bits. Get into a strolling mood with warm-up exercises. Watch white doves released to the sky. Write notes at the Memory Station, back by popular demand. (Connued on page 5)

Transcript of CRASH COURSE HITS 1000 - NAMI Contra Costa mail: [email protected] NAMI SPANISH...

NAMI Contra Costa September 2017 1

Contra Costa’s Voice on Mental Illness July 2014 61714 1200P

The NAMI Contra Costa Newsletter is available on the web at: www.namicontracosta.org

You can get a copy of this newsletter and/or the electronic newsletter by e mailing: [email protected]

Email: [email protected] Phone Number 24/7: (925) 465-3864 Office Number: (925) 942-0767 If Your Family Faces The Challenge of Mental Illness . . . E mail: [email protected] and/or crashcoursehelp@ aol.com

September 21, 2017 GENERAL MEETING

7:00 - 9:00 p.m.

Thursday, September 21, 2017

SPECIAL PRESENTATION

Dr. Steven Seager

Dr.Seager will Present his film

“Shattered Families”

The Collapse of America’s

Mental Health System

Dr. Seager is a psychiatrist, author and

filmmaker. He will show his latest film

“Shattered Families” which details the problems with the current mental health

system.

Dr. Seager, a former Emergency Room physician, has been a psychiatrist for 25

years specializing in the treatment of the mentally ill.

Dr. Seager will be open to answering

your questions. He currently works at the Contra Costa

Regional Medical Center

(County Hospital).

Location:

John Muir Hospital Concord Campus

2540 East Street Concord

Open To The Public- Free Admission

CRASH COURSE

HITS 1000

As this NAMI Newsletter

goes to press, the Crash Course has

served over 1000 troubled fami-

lies.

Founded in February of

2016 by the Behavioral Health Ser-

vices, Miller Wellness, Family Jus-

tice Center and the managing part-

ner, NAMI Contra Costa, it has

been offered every Wednesday

evening at the Family Justice Center

in downtown Concord.

The Crash Course has fea-

tured a compre-

hensive orienta-

tion to the men-

tal health field

in Contra Costa

County. It of-

fers an introduc-

tion to and de-

tails about the

services a fami-

ly would need to

manage a psy-

chiatric case.

The lead author of the ma-

terial was Kimberly Krisch of the

Miller Wellness Center.

(Continued on page 4)

Kimberly Krisch Miller Wellness Center

NAMI IN MOTION COMMUNITY EVENT &

FUNDRAISER Let the good times roll.

Join the NAMI in Motion stroll,

Saturday, October 7, 9 AM to noon,

Pleasant Hill Park, 147 Gregory

Lane.

Fun for kids and the young at

heart, your pets, too, but on a

leash, please. Free face painting,

cupcake decorating, bounce house,

and bubbles floating playfully in

the air. Grab some free fruit and

water and listen to live music by

the Herb Putnam Clubhouse musi-

cians. Anticipate a number of raffle

prizes, including male and female

Fit Bits. Get into a strolling mood

with warm-up exercises. Watch

white doves released to the sky. Write notes at the Memory Station,

back by popular demand.

(Continued on page 5)

NAMI Contra Costa September 2017 2

NAMI-CC Care and Support Groups Central Contra Costa County

3rd Monday of Each Month, 7:00 to 9:00 p.m., John Muir Medical Center , 1601 Ygnacio

Valley Road, Walnut Creek Campus, downstairs in the Epstein Conference Room. Park in the

FREE public garage on the La Casa Via side of the hospital. The group is facilitated by Sharon

Madison and Bob Thigpen. Email: [email protected], or call: (925) 256-9640, (925) 676-5771.

Open Our Hearts

Family Member Support Group For family members of adults with mental illness.

4th Monday of Each Month 7:00 pm to 8:30 pm

Temple Isaiah

945 Risa Road, Lafayette

(In The Talmud Torah Center, Room E204)

Call Karen at (925) 945-7272 or

email at [email protected]

www.openourhearts.net

NAMI Contra Costa Writers’ Group All writing levels welcomed. 1st Tuesday of Each Month

10:30 a.m. to 12:00 Noon

Rainbow Center-2118 Willow Pass Road, Concord Roberto Roman 925-957 5105

Margaret Netherby, facilitator, [email protected].

Support Group for Parents of

Adult Children with Mental Illness Meets the 2nd Sunday 2-3:30 pm

San Ramon Valley United Methodist Church 902 Danville Blvd., Alamo, CA 94507

Karen Scalzi: (925) 820-7495 or [email protected]

Marilyn Clarke: (925) 837-5243 Office: (925) 837-5243

NEW HOPE SUPPORT GROUP

Offering support, education and resources to parents, caregivers of children, teens and young adults diagnosed with a mood disor-

der. Meets the 2nd Monday of Each Month

Lafayette/Orinda Presbyterian Church 49 Knox Drive, Room 204, in Lafayette

7:00 to 9:00 p.m. Christina Mellin 925-899 0862

NAMI CC Mandarin Program Family Support Group

Language: Mandarin中文 2nd Saturday of every month

Time 10:00 to 12:00 Noon Location: DCBC, 2278 Camino Ramon, San Ramon,

CA 94583 Contacts: Shelly 925-238-6286; Jane 925-406-9526

[email protected]

NAMI West County Support Group 2nd Wednesday Each Month 6:30—8:00 pm

Richmond Medical Center of Kaiser

901 Nevin Avenue– 3rd Floor Room 317 Conference Rm 1 Richmond Contact Dr. Sumchai 510-237 9277 or

E mail: [email protected]

NAMI SPANISH LANGUAGE

FAMILY SUPPORT GROUP—PITTSBURG

1st Thursday each month 7:00-8:30 pm

Faith Based-ALL Creeds Welcome!

Church of the Living God

1125 Harbor St. Pittsburg

Veronica: 925-250 4032

defamiliaafamilia@namicontracosta

The Crash Course A comprehensive orientation to the

resources in Contra Costa to help

with recovery

EVERY Wednesday night 6:30 pm

2151 Salvio St. Concord 2nd Floor

[email protected] 925-676 5771

Free-RSVP NOT Required

Brentwood Support Group Last Monday Evening of the Month

Raley’s Grocery Store

2400 Sand Creek Road, Brentwood

7:00 pm to 9:00 pm

Contact: Laurel Howard-Fong 925-437 1751

[email protected]

NAMI Contra Costa September 2017 3

NAMI Contra Costa

National Alliance on Mental Illness

OFFICERS:

Charles Madison, President

(925) 256-9640 [email protected]

Douglas Dunn 1st Vice President

[email protected]

Yan Bennis, 2nd Vice President

[email protected]

Mark Cohen, Secretary

[email protected]

David Kahler, Treasurer (925) 676-5771

[email protected]

BOARD OF DIRECTORS

Kay Derrico Barbara Scott Susan Horrocks Phil Belisle

Al Farmer

Shelly Ji Don Green

COMMITTEES:

Don Green Criminal Justice

Shelly Ji Mandarin Groups

Susan Horrocks Membership

David Kahler Publishing

Veronica McManus F 2 F Spanish

Barbara Scott Nominating Committee

Nancy Seibert Family-to-Family

Clare Beckner Database

Richard Derrico Behavioral Health Court

Gigi Crowder FaithNet Coordinator

Phil Belisle Internal Auditor

Kay Derrico Outreach Committee

Steve Sullivan Librarian

Douglas Dunn Political Advocacy

Newsletter Group Fran Martin

Peggy Luna Dick Owens

David Kahler Karin Baker Greg Beckner

Rich and Yvonne DeAndre

Email: [email protected] Website: www.namicontracosta.org

Phone: (925) 676 5771 90217 1219PCCCC

Newsletter Deadline:

20th of Each Month

PRESIDENT’S

COLUMN By Charles Madison

FAMILY ADVOCATE

Bob Thigpen 925-957 5139

[email protected],

Bob Thigpen is the County’s Family Advo-

cate. You can talk directly with him at the Crash Course

which is EVERY Wednesday night

(925-676- 5771)

E mail: [email protected]

NAMI Contra Costa Mission Statement

Our Mission is to Provide Support, Outreach, Edu-

cation and Advocacy to Families affected by and In-

dividuals living with a mental illness.

SAVE THE DATE: The next

NAMI In-Motion is planned for

October 7th in Pleasant Hill. This

will be a fun event for all. Just go

to the NAMI website and set up

your team or join one of the teams

already set up.

This is an important

fundraiser with some warmup

exercises, a raffle and fun things

for the kids. Among the raffle

items are male and female Fit

Bits. Bring the whole family in-

cluding your pets. You can also

sign up as a virtual stroller. So go

to the website and get it started.

We will host a brunch on

September 9th at 11 am at our

home for all team captains. We

will discuss and exchange ideas

on how to grow your team. If you

plan to come to the brunch RSVP

to [email protected] with

your phone number and we will

call you with details.

Don’t forget, we will be

acknowledging the top fundraiser

teams.

On Thursday, August

17th Aram Boyd provided a fun

and very interesting presentation

on how to get better results from

every relationship

See page 1 for the September

program.

YOU ARE INVITED!

Please join us as we honor

KAY DERRICO*

Thursday, September 21, 2017

NAMI GENERAL MEETING

Just before the meeting begins.

6:45 - 7:00 PM

REFRESHMENTS SERVED

General Meeting Program

SHATTERED FAMILIES FILM

Presented by Steven Seager,

M.D., Creator

Followed by Q. & A.

*Kay is retiring from the NAMI

Board of Directors after many,

many years of service.

She will become our very first

Emeritus Board Member.

NAMI Contra Costa September 2017 4

FAMILY TO

FAMILY

2017 Fall Courses

Richmond starts Aug 31

Lafayette starts Sept 11

Register:

[email protected]

By: Nancy Seibert

As Program Coordina-

tor, I am very proud of our

Teaching Team of over twenty

Family to Family facilitators who

have served this 2017 year

through presentations of nine

courses. In three languages,

English, Spanish and Mandarin,

Family to Family curriculum has

offered facts and discussion

which assists people through edu-

cation and with empathy.

I would like to give

recognition to members of the

Teaching Teams. Each teacher is

certified by a NAMI CA state

trainer and is experienced as a

first- degree relative of a family

member diagnosed with a mental

illness disorder. The teachers are

positive and motivated persons

who give of themselves as course

facilitators and leaders: Gloria

Beltran, Julia Bonacich-Fertziger,

Gloria Chang, Jane Chao, Thom-

as Cloney, Mark Cohen, Tamara

Dayton, Edward Dayton, Vickie

Deem, Karen Deli, Alejandra

Escobedo, Noor Al Forsland,

Victoria Ghulam, Kirsten Heher,

Shelly Ji, Sherry Jin, Nancy Jor-

dan, Tony Khalil, Janice Khalil,

Raoul Maltes, Mercedes

Marquez, Marla McGaw, Veroni-

ca McManus, Rosa Menjivar,

Pamela Nelson Walker, Baby

Raff, Dan Shortenhaus, Mujahi-

dun Sumchai and Nestor Vaschet-

to.

Families and the entire

county benefit from the Family to

Family Education Course curricu-

lum presented in three languages

and the contribution of these fine

class facilitators and leaders.

Thank you Teaching Teams!!

Contra Costa

Behavioral Health

Access Line 1-888-678 7277

Note: The Crash Course contact information

will be added to the Access Line

Information beginning October 1, 2017.

The Behavioral Health

Access Line is the gateway to Con-

tra Costa County’s Behavioral

Health system of care, welcoming

consumers to integrated services for

mental health, substance use and

homelessness. It is the main point

of entry into the county’s Mental

Health Clinics and Substance Use

Disorder treatment programs. It is

also the Mental Health Plan Author-

ization Line for Contra Costa Medi-

Cal Beneficiaries seeking Specialty

Mental Health services with the

Provider Network.

Although the Access Line

is available to consumers who have

Medi-Cal insurance or may be Medi

-Cal eligible, it is also a behavioral

health resource line for Contra Cos-

ta residents, providing information,

referral and crisis triage/support to

all callers. The line offers 24-hour

availability and assistance in all

languages via staff or interpreters.

As the “front door” to

integrated services, all individuals

and families with substance use,

mental health and homeless issues

are welcome to call and receive

help through the Behavioral Health

Access Line. The Access Team

embraces a person-centered and

complex-capable approach, ensur-

ing that co-occurring issues are

addressed by building them into the

screening/triage process itself. As a

call center and community resource

line it values efficiency and re-

spect.

The program’s mission is

to be a welcoming and responsive

entry point into our system.

SPECIAL

GENERAL

MEETING Thursday, October 19

Dr. Steven Seager has

produced two films on the men-

tal health system and it’s prob-

lems. The first film is titled

“Shattered Families” and will be

the feature of the September Gen-

eral Meeting. It describes the

problems in the system.

His second film

“Roadmap” explains how to fix

the problems. It will be the fea-

ture of the October 19, General

Meeting. This will be a meeting

you won’t want to miss.

This will be “Roadmap’s” first

public showing.

Dr. Seager’s earlier book

was “Behind the Gates of Gomor-

rah: A Year With the Criminally

Insane.” It was released in 2015

and was an international bestsell-

er.

“Roadmap” proposes a

new mechanism for fixing our

broken mental health system. It

is a blueprint to ultimately de-

crease and hopefully eliminate

these problems altogether. More

immediately, “Roadmap” is a

cogent, straightforward guide for

families traversing a decaying

system that has maintained archa-

ic and deficient policies prevent-

ing them access to quality care

for their sick loved ones.

NAMI Contra Costa September 2017 5

NAMI BASICS Course for Parents of Children

or Adolescents

What: NAMI Basics, a free, six-

session program for parents and

other family caregivers of chil-

dren with emotional and behav-

ioral difficulties.

Where: Concord

When: soon, 6 Saturdays, 9 am

to noon

Contact Nancy

[email protected]

or leave a

message with the NAMI CC

Answering service 925-942-0767.

E Mail: [email protected]

WE DID IT! MEMBERSHIP

CHALLENGE MET

Last May, an anony-

mous donor issued a Membership

Challenge to match all member-

ships from May through July up to

$1000. We are proud to announce

we have met the challenge and

received the full $1000. Thank

you to all of you who joined and/

or renewed your member-

ships. Thanks to you our mem-

bership ranks are growing, our

volunteer rates increasing and our

programs expanding throughout

Contra Costa County.

Please check the label on

your monthly newsletter for your

membership expiration date. Al-

so, be sure to sign up to receive

our free, monthly A RAY OF

SUNSHINE eNEWS via

email. Look for your copy in your

inbox the first week of each

month. If you are not receiving

your copy simply go to our web-

site www.namicontracosta.org and

enter your email address to sign

up. It is free and packed full of

important announcements.

CRASH COURSE

HITS 1000 (Continued from page 1)

Krisch was a member of

the “Committee of 10” which re-

searched the material for the pro-

ject. A 120 page book was writ-

ten which then became the 165

slide presentation.

The Crash Course is given

every Wednesday, without excep-

tion. If Christmas or the 4th of

July come on a Wednesday, there

will be a Crash Course at the regu-

lar time.

The program is free and

no reservation is required. Many

people come early to discuss the

particulars of their family crisis.

One of the main goals is

to get one of

the family

members to

become the

Family Case

Manager.

To

do that they

would follow

the “Survival

Guide” which

has been on

the NAMI

website for

years. It

instructs them

to set up an

orderly set of

files, create a

journal, and

craft a “One

Page Sum-

mary”.

There are usually four

speakers. Greg Beckner discuss-

es his experiences with medications

and hospitalizations. Robert Thig-

pen covers the subject of Conser-

vatorship/Guardianship. Bob also

fields the general questions. Cris

Wallace introduces Recovery Inter-

national and Dave Kahler over-

sees the presentation.

Greg Beckner

Robert Thigpen

BRUNCH INVITATION

Consider being a NAMI in Motion Team Captain and join us at brunch. What: free brunch for NAMI in Motion Team Captains and co-captains or assistants When: Saturday, September 9, 2017, 11:00 AM Where: 600 Rock Oak Rd., Wal-nut Creek, CA 94598 About the brunch: Informational, inspirational, social event hosted by the Madison family. How to become a team captain: go to www.namicontracosta.org. Top fundraising teams will be acknowledged. RSVPs are helpful: Charles or Sharon 925-256-9540 or [email protected]

NAMI IN MOTION (Continued from page 1)

Get information from mental health organizations, ready to give you literature and answer your questions. Free sign-ups. Register at www.namicontracosta.org as an individual, join a team, or create a team of your own; or sign up as a virtual walker; or you can register at the event. See separate article inside this newsletter for a Brunch Invitation to team captains, co-captains, and assistants. Let’s raise some funds for NAMI programs directly helping over 1,500 people every year! Top fundraising teams will be acknowledged. Donate on-line at www.namicontracosta.org individually or through a team, or mail a check made out and sent to NAMI in Motion at 550 Patter-son Blvd., Pleasant Hill, CA 94523. Want to volunteer the day of the event? Contact Barbara Scott [email protected].

NAMI Contra Costa September 2017 6

KAISER SETTLES MENTAL HEALTH ACCESS CASE

Editor’s Note: This article was excerpted from the San Francisco Chronicle from a

July 21, 2017, article by Jenny Gold..

Gold is a senior correspondent with Kaiser Health News. Her e mail address is:

[email protected]

California insurance reg-

ulators announced this week (July

2017) that they have reached a

settlement with Kaiser Perma-

nente to address its repeated

failures to provide patients with

timely access to mental health

services.

Under the agreement,

which was the result of two years

of negotiations between the state

department of Managed Health

Care and Kaiser Foundation

Health Plan. Kaiser has agreed to

hire an outside consultant for three

years to help it address the access

problem and improve oversight of

its behavioral health program.

The agreement also

acknowledges steps the plan has

already taken to improve access,

including hiring 850 additional

behavioral health therapists in the

past five years.

“This is a really huge

deal, and it’s going to impact the

lives of millions of Kaiser

(health plan) members who need

mental health services,” said

Shelley Rouillard, director of the

managed care department, one of

the state’s two insurance regula-

tors. “For the first time Kaiser has

committed to fixing the access

problems that their enrollees have

had in regards to mental health

services.

The plan agreed to make

corrections in six areas, including

identifying all patient requests for

appointments that do not meet the

state’s “timely access” rules. If

the plan fails to meet benchmarks

laid out in the agreement, it could

incur up to $1 million in fines.

In a statement posted

on the Kaiser Permanente web-

site, Dr. Patrick Courneya, Kai-

ser’s executive vice president

and chief medical officer wrote

that the agreement “shows the

path for continued improve-

ment. More importantly, it is an

acknowledgement of the signifi-

cant achievements that Kaiser

Permanente has made in our

ongoing work to improve men-

tal health care in California.”

In an additional state-

ment, Courneya said: “We have

invested in skilled therapists

and physicians, adding new

facilities and making many oth-

er improvements over the past

several years.”

The settlement follows

years of warnings by the man-

aged care department that Kai-

ser was violating state law

by failing to get patients into

appropriate treatment soon

enough. As a result, Kaiser in

2013 agreed to pay a $4 million

fine—one of the largest paid by

an insurer in the state.

In 2015 the department

found that some Kaiser patients

still had to wait weeks or even

months to see a psychiatrist.

One example cited in its report,

a sexual assault

victim diagnosed with post-

traumatic stress disorder and

major depression was pre-

scribed an antidepressant in an

initial visit but struggled to

obtain a follow-up appoint-

ment.

The patient, who was

not identified, tried to get both

individual and group therapy

visits, according to the report.

Her psychiatrist responded by

“offering psychotherapy in the

community

at the patient’s expense.” Plan

group therapy did not address sex-

ual assault.

The patient was eventual-

ly able to schedule an ap-

pointment with a Kaiser therapist-

five months after her initial visit,

the report said.

Rouillard said the man-

aged care department has been

working closely with Kaiser on a

settlement since the 2015 report.

“If we were to fine them

another multimillion-dollar fine,

that wouldn’t really fix the prob-

lem,” Roullard said. We really

needed them to commit to spend-

ing their vast resources on fixing

problems.”

The agreement “closes

out the deficiencies identified in

past surveys and starts the clock

all over again as of today,” Rouil-

lard said.

Patients who experience

problems with access to health

care, whether they are insured by

Kaiser or another plan can contact

the Department of Managed

Health Care Help Center.

KAISER HIT AGAIN ANOTHER HUGE FINE

In a August 3, 2017

article by Chad Terhune the

East Bay Times reported that

Kaiser was hit again with a

$2.2 million fine.

The fine was for fail-

ing to provide data on patient

care to the state’s Medi-

caid program.

NAMI Contra Costa September 2017 7

NAMI CONTRA COSTA DONATIONS

In Memory Of:

Brent Farmer

Son of Al and Sue Farmer

Note:

There is a

Brenton N. Farmer Memorial Fund

namicontracosta.org or

NAMI Contra Costa

P.O. Box: 21247

Concord, CA.

94521

Below is a partial list of donors:

Duane and Joan Essex Bobbi Dean Betty Wagner

Ashley Tupper K. and L. Kinrade Daniel and Jane Voll

Charles Madison Mark Cohen David Kahler Walter Ross

Andrew Gauseman Edward Munson Jay Slade Cyrus Martinson

Toni and Jim Jeraulud Milo Yoshing Dana Francis Gallagher

Larry and Susan Ricksen Tracy Murray Walter Cannon

Josine Kister Wood Gary and Vicky Yancey Margaret Boscoe

Mae Bragen Marie Overby Thomas and Karen Norris

Dr. Edward Cane Elmer Anderson George and Jean Marshall

Gene and Lily Schulting W. Devin Farley Robert Morris

In Memory of:

Dale Watson

David Kahler Dick Owens Bob Zimmerman

In Memory of:

John Macaluso

From: Penny and Louis Wong

In Memory of:

William Lesser

From: Mary Howard and Bruce Lesser

Brent Farmer

December 29, 1979

July 27, 2017

NAMI Contra Costa September 2017 8

NAMI Contra Costa

P.O Box 21247

Concord, CA

94521

Phone: (925) 465-3864

Email: [email protected]

Stamp

DONATION FORM

Amount ___________ Mail to:

Treasurer, NAMI Contra Costa

P.O. Box 21247, Concord, CA 94521

Note: Tax ID #68-0209474

(No goods or services have been received

from the following donor or donors)

Name ____________________________________

Address __________________________________

City _________________ Zip ________________

Phone ________________ Cell _______________

Email Address ____________________________

3rd Monday Support Group September 18, 2017 7:00 p.m.

John Muir Medical Center

Walnut Creek

Epstein Meeting Room

Basement Area (See page 2)

Email: [email protected]

To:

From:

APPLICATION FOR MEMBERSHIP

NAMI CONTRA COSTA Make check payable to NAMI Contra Costa

Complete this information and please return to:

Treasurer

NAMI Contra Costa

P.O. Box 21247

Concord, CA 94521

Name

_______________________________________

Address ______________________

City _________________ Zip ___________

Phone _________________ Cell ___________

Email Address: _____________________________

___________________________________________

______

Renewal New Member

Open Door $ 5 General Membership $40

Household $60