Request Wellness Support

The ODA Wellness program matches dentists and dental students in need with a Wellness Ambassador who has gone through a similar situation or is familiar with a specific aspect of Wellness. Please complete the brief form below to be put in touch with an Ambassador.

*Please note this is a peer to peer support program that is completely confidential. Wellness Ambassadors are dentist colleague volunteers, not mental health professionals.

If you or someone you know is suicidal or in emotional distress, contact the National Suicide Prevention Lifeline at 1-800-273-8255.

First Name

Last Name

Best Phone Number to Reach You

Are you a member of the ODA?

Yes
No
Unsure

Who is this support request for?

You
A family member
A co-worker
A colleague
Other... This choice will expand a text box

Please provide additional information on your specific situation to better assist us with pairing you with a Wellness Ambassador. All information is keep confidential and will not be shared beyond the Wellness Ambassador.

We make every effort to put you in touch with an Ambassador within 24 hrs during business days (Monday-Friday). If you are not contacted in 24 hrs, please reach out to Dr. Barry Taylor Executive Director, at 503-218-2010 ext 2011 btaylor@oregondental.org or Heather Langdon Membership Coordinator ext 2007 hlangdon@oregondental.org

Request Wellness Support

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