Pilot Registration Form
We Need You Here.
Help shape a better future for veteran mental health. Join our Pilot Program.
Veteran StatusVeteranActive DutyReserveNational GuardFamily MemberNot Applicable
Branch of ServiceArmyNavyAir ForceMarine CorpsCoast GuardSpace Force
Service start date:
ETS:
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CountyBarnstableBerkshireBristolDukesEssexFranklinHampdenHampshireMiddlesexNantucketNorfolkPlymouthSuffolkWorcester
Interested as:
VeteranClinicianPeer Support VolunteerResearch PartnerCommunity Partner
I have read and agree to the Participant Consent and Agreement.
I have read and understand the applicable Informed Consent Agreement. I understand that participation in any formal research study may require a separate study-specific consent.
I understand that Frontline Connect is not an emergency service and is not a substitute for medical or psychiatric diagnosis, treatment, or crisis intervention. If I am in crisis or immediate danger, I should call 911, or call or text 988 to reach the Suicide & Crisis Lifeline. Veterans may press 1.
I understand that Frontline Connect uses artificial intelligence to review my check-ins. If a safety concern is detected, authorized support personnel may review relevant check-in content and contact me. I understand this review and follow-up is a safety support, not a guarantee.
I understand that Frontline Connect administrators have full access to my chat logs and can access and review my conversations at any time, for safety, security, and operational purposes.
I have read and agree to the Privacy Policy and Terms of Use.
Register for the Pilot Program
Your information is secure and will only be used for the pilot program.