Donate Now

Confidential Support Request

Confidential Support & Mentorship Request

This form is for veterinary professionals who would like confidential support, mentorship, or guidance. It is designed to help us understand what kind of support would be most helpful and how we can respond appropriately. This form is not anonymous, because contact information is needed to follow up. Your information will not be shared with your employer or workplace. This form is not a crisis service and is not monitored in real time. If you are in immediate danger, please contact emergency services or the 988 Suicide & Crisis Lifeline.

This field is for validation purposes and should be left unchanged.

Section 1: Contact Information

First name is sufficient.
Only if you prefer phone or text communication.
How would you prefer we contact you?(Required)

Section 2: Your Role and Context

Section 3: What Kind of Support are You Seeking?

What type(s) of support are you interested in?(Required)

Section 4: What You’re Dealing With (Optional)

Which of the following are currently contributing to your stress or burnout?
Which statement best describes how this stress is affecting you right now?

Section 5: Mental Health & Safety

The following questions relate specifically to your personal mental health and well-being, not general world events or external stressors.
Have you experienced any of the following recently?
Select all that apply. This question is optional.

Section 6: Optional Mental Health Check-In (PHQ-9)

The following questions come from the Patient Health Questionnaire-9 (PHQ-9), a commonly used mental-health screening tool. This section is optional. It is not a diagnosis, and you may skip any or all questions.
Not at allSeveral daysMore than half the daysNearly every day
Little interest or pleasure in doing things
Feeling down, depressed, or hopeless
Trouble falling or staying asleep, or sleeping too much
Feeling tired or having little energy
Poor appetite or overeating
Feeling bad about yourself — or that you have let yourself or others down
Trouble concentrating on things
Moving or speaking more slowly than usual, or feeling unusually restless
Thoughts that you would be better off dead or of hurting yourself

Section 7: Safety Check (Required)

Safety Note

If you are in immediate distress or feel unable to keep yourself safe, please contact: 988 Suicide & Crisis Lifeline (U.S.) — Call or text 988 or your local emergency services. This form is not monitored in real time.