Gutsy Peer Support Mentee Application Form

In order to participate in our Gutsy Peer Support program you must complete this form below and agree to our program’s policies and code of conduct. Please note that the email address that you provide will be shared with one of our volunteer mentors. You must be 18 or over to participate in this program.

Once you have completed this form, please click submit. All required fields will be marked with an asterisk (*). You cannot submit your application without completing these required fields.

If you have questions, please contact us at 

(if you do not feel comfortable providing your first name, please provide a name that you’d prefer for us to share with your mentor)
(please note, this email address will be shared with one of our volunteer mentors)
( ) -
What is your gender:

Would you prefer to be connected with a mentor of the same gender as you?:

What language(s) do you feel comfortable communicating in (select all that apply):

Please indicate language preference
please provide specific information if you selected "Other" from the dropdown above
Can we share your above diagnosis information with your mentor?:

(please indicate calendar year)
Are there any specific topics that you would be most interested in speaking with a mentor about, based on your current needs (select the three most important)? :

Please specify which types of surgery
For example, what do you hope to get out of participating in this program?

  • Canada has among the highest incidence rates of Crohn's and colitis in the world.
  • 1 in 140 Canadians lives with Crohn’s or colitis.
  • Families new to Canada are developing these diseases for the first time.
  • Incidence of Crohn’s in Canadian kids under 10 has doubled since 1995.
  • People are most commonly diagnosed before age 30.

Other Areas of Interest