Psoriasis One to One program

Apply to be a peer mentor or coach

Please complete this form to apply to be a volunteer mentor or coach in the Psoriasis One to One Program. Your application will be reviewed by our staff. We will be in touch with you as soon as possible. Thank you for your interest in this program.

Psoriasis One to One Application

Psoriasis One to One Program: Volunteer

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Please check the appropriate item.

Indicate which type(s) of psoriasis you have experienced.

Check any that apply

Please check the items that best describe your psoriasis/psoriatic arthritis and current treatment.

Please feel free to share any information about treatments that have or have not worked for you.

Please tell us why you would like to be a psoriasis peer mentor or coach.

What skills and/or experience do you have that you can utilize as a volunteer?

Are you interested in learning about other volunteer opportunities at this time? If yes, please check the boxes next to the topic of interest and we will provide you with more information.

In order to become a One to One volunteer with the Psoriasis Foundation, you will need to complete a training session, brief telephone interview with the program manager, and sign a volunteer waiver form and confidentiality agreement . Are you willing to do this in order to be considered for this volunteer position?

First personal reference who is not related to you.

Second personal reference who is not related to you.

Please read the following carefully before authorizing
your signature on this application

I understand that this is an application, not a guarantee of a volunteer opportunity.

I certify that all information I have provided on this application and/or given during my verbal interview is true and complete to the best of my knowledge and that I have not withheld facts that would unfavorably affect my application for a volunteer position. I further certify that I will continue to provide information that is true and complete to the best of my knowledge. I understand that the National Psoriasis Foundation will verify the information that I have given and that misrepresentations or omissions may be a cause for my immediate rejection as an applicant for a volunteer position with the National Psoriasis Foundation or my termination as a volunteer.

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