APNI - Association for Post-Natal Illness

Volunteer Application Form. I would like to become a volunteer for The Association for Post Natal Ilness.

Name:
Email:
Phone:
Your Address (including postcode):
1. How soon after the birth of your child did you become depressed?
2. Date of birth of your children?
3. Did you suffer after each birth?
4. How long did your depression last?
5. Did you take any drugs for depression, if so which ones?
6. Do you have strong feelings for or against drug treatment?
7. What was the main feature/symptom of your illness?
8. Have you had any previous depressive illness?
9. If so, was the illness subsequent to childbirth?
10. Have you had any previous mental ill health before post natal depression?
11. How long have you been well since your episode of post natal depression?
12. Are you still taking any medication? If not when did you stop?
13. Have you ever suffered from migraine?
14. If you breast-fed your baby, did you use any drug treatment? (Please name)
15. Are you able to offer support by email? If so please enter email address
16. Would your partner be prepared to talk with partner of a currently depressed mother? If so enter your partner's name:
17. Would you be willing to do postal support?
18. Are you willing to talk to journalists about your experience of post natal depression?
19. Did you suffer with ante-natal depression?
20. Are you able to do talks for professional groups about your experience of PND?
21. Do you speak any languages? If so please state which:

Please write any comments that you feel may be relevant or helpful:

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Charity Registration Number: No. 280510 (registered in UK)

APNI - Association for Post-Natal Illness

Volunteer Application Form.