Hey there! Thanks for your interest in Being Herd.

This form helps us get to know you and your mental health journey a little better. At batyr, we believe every story matters and has the potential to make a positive impact - so we’d love to hear yours.

In this form we’ll ask questions about your experiences and supports to make sure you’re in the best spot to join a workshop. Sometimes reflecting on your journey can feel tough, so if that happens please take a break and lean on your supports, or check out these services here.

This form should take about 10 minutes to complete. If you get stuck or would rather jump on a call instead of completing this form, email us at beingherd@batyr.com.au and our team will be in touch.

Just a heads up, what you share will only be seen by the batyr team and the Youth Support Person at your workshop. You can read our full Privacy Collection Statement here, or contact us at hello@batyr.com.au with any questions.

First Name

Last Name

Pronouns

Pronouns: Other

Date of Birth

Reminder Being Herd is for 16-30yrs

Email

Phone

Postcode

Suburb

State

Emergency contact's full name

Emergency contact's phone number

Emergency Contact's relationship to you

Relationship: Other (please specify)

Are you of Aboriginal origin, Torres Strait Islander origin, or both?

What cultural background do you identify with?

Preferred Language

Which Institution?

What Institution?

Are you an international Student?

How did you hear about batyr?

What mental health organisation?

Which mental health professional?

What event?

Have you ever been formally diagnosed with a mental illness and/or disorder?
Please remember, you do not need a formal diagnoses to attend the workshop.

Formal diagnoses

Experience: Other (please specify)

Support: Other (please specify)

Please give us a brief outline of the key challenge(s) in your journey?

What interests you about the workshop?

What is your preferred communication method?
Note - we will send important workshop updates via email

I agree to the Privacy Policy

Abuse	Academic pressure
Anxiety	Being in carer role for someone
Bipolar	Body Image Difficulties
Bullying (including cyber bullying)	Depression
Discrimination	Disordered Eating
Family expectations	Family Member with Mental Ill Health
Friend with Mental Ill Health	Grief
Isolation/loneliness	Long-term physical illness or injury
Mania	Obsessive Compulsive Behaviors
Panic Attacks	Personality Disorder
Psychosis	Relationship difficulties
Self-harm	Sexual Assault
Social disadvantage, poverty, or debt	Stress/Pressure
Substance use	Suicidal Thoughts
Suicide Attempt	Trauma
Other

Counsellor	Family
Friends	GP
Groups	Other Mental health professional
Other organisation	Psychiatrist
Psychologist	Religious organisation
Online forums	Online (other)
Other (please specify)