We're happy to be able to provide mental health funding to former federal workers who've lost their jobs in 2025. Please complete this application to be considered for our emergency mental health subsidy. One of our fellows will respond as soon as possible with an update on your application. NOTE: subsidies are awarded on a first come, first serve basis as inventory allows.

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- Step 1 of 5

Name *

First

Last

Preferred Name

Pronouns

State of ResidenceAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashington, D.C.WashingtonWest VirginiaWisconsinWyoming

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Email *

Phone *

We won't call you unless it's an emergency.

Which best describes you?I worked for the federal government as an employeeI worked closely with the federal government as a contractorOther

Other career

How many years have you been employed in this or a similar industry?1 or fewer years2-5 years6-10 years11-15 years16-20 yearsMore than 20 years

Are you currently employed?YesNo

What was your last date of employment?

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Do you currently have a licensed mental health practitioner that you’re seeing or would like to go back to seeing?YesNo

Do you currently have insurance that covers the cost of therapy?Yes, I have insurance but it doesn’t cover therapyYes, but it doesn’t cover the therapist I want to seeNo,I do not have insurance

What brings you to Mind the Movement?

• Anxiety
• Depression
• Burnout
• PTSD
• Workplace trauma
• Substance use/ Addiction
• Seeking general Mental Health Resources
• Grief/Loss
• Other

How satisfied are you with your life right now?

Selected Value: 1

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Where did you learn about Mind the Movement?

Anything else you’d like us to know?

this Where else

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Emergency Contact *

First

Last

Emergency Contact Phone Number *

Emergency contact relationship to you *

Disclaimer *

I agree to complete monthly surveys for Mind the Movement with updates on my professional status and other qualitative data that will help us improve the program.

Disclaimer *

I understand that this funding will be paid directly to my mental health care provider and not to me as an individual.

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