Trellis Participant Application
If you are new to Trellis programs, please complete this application and a team member will contact you within 3 business days. If you are unsure which program is the best fit, please contact firstname.lastname@example.org.
We request that you be able to commit to at least 8 sessions so that you can fully benefit through regular participation. Becoming a regular participant will allow you to build important social connections and make progress towards your personal health and wellness goals.
The personal and medical information that you provide on this form will be managed by Trellis as confidential. Demographic information may be used to report to grant funding agencies.
Required for first-time applicants. Paper application is available upon request.