Thank you for your interest in our Power of Two program! Please review important information about the program below.

  • Power of Two is our peer-to-peer support program where we can pair those seeking support with an IBD patient or caregiver over the phone.
  • Our peer supporters are fellow patient/caregiver volunteers and cannot provide medical advice or counseling services.
  • The program is short-term and you will typically have 1-2 calls with your supporter. An automated phone line is generated for the calls, so personal contact information is kept private.
  • We can make personalized matches based on your preferences including age, gender, medication, surgery, and more.
  • If you have additional questions about the program, please call the IBD Help Center at 888-694-8872 x8 or e-mail powerof2@crohnscolitisfoundation.org .

Please complete the below application. We will make the best match possible with the available peer supporters but may not be able to make a match based on all of your requests.






Application

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  Personal Info

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What's this?

 
Question - Not Required - Peer Match Notification

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* Type of IBD
(Select one of the available choices or enter a different value.)



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Question - Required - Severity of Disease




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Question - Required - Which of the following symptoms do you/your loved one have?
Please make at least 1 selection from the choices below.

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Question - Required - Do you or your loved one experience any of the following complications?
Please make at least 1 selection from the choices below.

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Question - Required - Which of the following matters most to you in matching with a peer supporter? Please note, we will do our best to match you according to your preferences.




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Question - Required - When can you be reached by phone? Your peer supporter will call you based on your listed availability. Please select the best days and time slots when you can be reached below:

 
Question - Not Required - Monday Times

 
Question - Not Required - Tuesday Times

 
Question - Not Required - Wednesday Times

 
Question - Not Required - Thursday Times

 
Question - Not Required - Friday Times

 
Question - Not Required - Saturday Times

 
Question - Not Required - Sunday Times

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Disclaimer: By submitting this application you consent to a peer supporter match through the Power of Two program. Your peer supporter cannot provide medical or mental health advice. Any information provided by your supporter should not replace your physician's advice. Always check with your personal physician before taking any action regarding your health.

   


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