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Lived Experience Partner - Interest Form

Lived Experience Interest Form

This form is intended for parents, caregivers, and youth with lived experience in child welfare, youth justice, mental health, or early childhood education who are interested in serving as a leader for systems change with the State of Wisconsin. We welcome you to share this form with others who you feel may be interested in learning more about lived experience leadership.

To learn more about Wisconsin's lived experience leadership efforts, please visit the Wisconsin Office of Children's Mental Health and the Department of Children and Families websites. 

If you have any questions about this form, please reach out to:
  • Bregetta Wilson at bregetta.wilson@wisconsin.gov or 414-750-8872
  • Andrea Turtenwald at andrea.turtenwald@wisconsin.gov or 608-445-0159
1. Please enter your contact information *This question is required.
2. How would you prefer to be contacted?
3. Your pronouns (select all that apply)
5. Which of these areas do you have lived experience navigating?
Reminder: These answers are confidential. If you are not comfortable discussing the topic, please do not select it.  *This question is required.
6. Is your child welfare / child protective services case currently closed?
7. I think big picture- I see how my experiences could benefit others. *This question is required.
8. On a scale of 1 to 5, my level of interest in learning and developing as a leader is… *This question is required.
 12345 
Not At All InterestedVery Interested
9. What is your general availability? Select all times you could be available with some notice. 
10. Why you are interested in becoming a lived experience partner? Select all that apply. *This question is required.
Verify you are human.
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