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Personal Information
Thank you for helping ensure our system is set up to meet peers where they are at. The NYPSCB is in charge of training and professional development for the NYCPS workforce and wants to make sure that our system is people first and person centered. We collect the following personal information to better understand the diversity of our workforce and to provide tailored resources and support. Your privacy is important to us, and all responses are confidential and used solely for research and analysis purposes.
Your Name
First
Last
Your Address
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
This is an opportunity for you to update your contact information.
Preferred Method of Contact
Email
Phone
Text
VRI
Your Email Address
Email Address
Confirm Email Address
Your Phone
Best Time to Call You
Select A Time
12:00 am
12:30 am
1:00 am
1:30 am
2:00 am
2:30 am
3:00 am
3:30 am
4:00 am
4:30 am
5:00 am
5:30 am
6:00 am
6:30 am
7:00 am
7:30 am
8:00 am
8:30 am
9:00 am
9:30 am
10:00 am
10:30 am
11:00 am
11:30 am
12:00 pm
12:30 pm
1:00 pm
1:30 pm
2:00 pm
2:30 pm
3:00 pm
3:30 pm
4:00 pm
4:30 pm
5:00 pm
5:30 pm
6:00 pm
6:30 pm
7:00 pm
7:30 pm
8:00 pm
8:30 pm
9:00 pm
9:30 pm
10:00 pm
10:30 pm
11:00 pm
11:30 pm
Gender and Identity
The New York Peer Specialist Certification Board (NYPSCB) collects information on gender and identity to ensure our workforce is inclusive and representative of the diverse communities we serve. This data helps us create supportive environments, tailor training programs, and advocate for equitable resources. Understanding gender diversity also allows us to identify and address any barriers faced by individuals of different gender identities, ensuring everyone receives the appropriate support and opportunities for growth. All responses are kept confidential and used to enhance inclusivity and improve our services.
What was your sex assigned at birth, as listed on your original birth certificate?
Female
Male
Unknown
Prefer not to answer
The New York Peer Specialist Certification Board (NYPSCB) collects information about sex assigned at birth to understand the diversity of experiences within our certified peer specialist community. This data helps us identify trends, provide appropriate resources, and create a supportive environment for individuals of all gender identities. Understanding this information helps us promote inclusivity and ensure that our programs and services are equitable. Your response is confidential and will only be used for research, analysis, and improving our support services.
What is your current gender identity?
Female
Male
Transgender
Nonbinary
Two-Spirit
Genderqueer
I use a different term (use "other" choice)
Questioning
Prefer not to answer
Other
The New York Peer Specialist Certification Board (NYPSCB) collects information about gender identity to ensure that we understand and represent the diversity within our certified peer specialist community. This information helps us provide appropriate resources, foster inclusivity, and advocate for the needs of individuals with diverse gender identities. By understanding gender diversity, we can better support our community and create a safe, equitable environment. Your response is confidential and will be used solely for research, analysis, and improving our services.
Which of the following best describes your sexual orientation?
Heterosexual (straight)
Gay
Lesbian
Bisexual
Pansexual
Asexual
Queer
Questioning/Not Sure
I use a different term
Prefer not to answer
Other
The New York Peer Specialist Certification Board (NYPSCB) collects information about sexual orientation to better understand and support the diversity of our certified peer specialist community. This information helps us create a welcoming and inclusive environment, tailor our services to meet the unique needs of LGBTQ+ individuals, and advocate for equitable resources. All responses are confidential and will be used to enhance our programs and ensure that all peer specialists feel represented and supported.
What is your ancestry?
Human
Human, with ancestry from Africa
Human, with ancestry from Asia
Human, with Ancestry from Europe
Human, with ancestry from North America
Human, with ancestry from Oceania
Human, with ancestry from South America
Other
We understand that this list does not capture anyone's unique background. If you would like, please use the "Other" box to self-identify. We collect this information to understand the diversity of our peer specialist workforce and to identify and address gaps in representation. Your response helps ensure that our services are inclusive and effective.
Military Service
The New York Peer Specialist Certification Board (NYPSCB) collects information about military service to better understand and support veterans within our workforce. Veterans bring unique experiences and strengths that can enhance peer support, particularly when working with individuals who share similar backgrounds. This data helps us provide targeted resources, advocate for support specific to veterans' needs, and ensure our programs are inclusive and accessible to those who have served. By understanding the military backgrounds of our peer specialists, we can create a more supportive environment and maximize the value of their experiences in their roles.
Have you ever served in the U.S. Armed Forces (including the Reserves or National Guard)?
Yes
No
Prefer not to answer
The New York Peer Specialist Certification Board (NYPSCB) collects information about veteran status to better understand the backgrounds and experiences of certified peer specialists. This data helps us provide targeted resources, training, and support for veterans who may have unique perspectives and needs. It also allows us to identify gaps in services, tailor our programs, and advocate for policies that benefit veterans in the peer support workforce. This information is confidential and will only be used to enhance our understanding and improve our services for all members of our community.
If yes, which branch(es) of the US Armed Forces did you serve in?
Air Force
Army
Coast Guard
Marine Corps
Navy
Space Force
National Guard
The New York Peer Specialist Certification Board (NYPSCB) collects information on which branch of the military you served in to better understand the diverse experiences and skills that veterans bring to the peer support workforce. Each branch offers unique training and experiences, and understanding this helps us create targeted support, training opportunities, and resources for veterans. This information also supports our advocacy efforts and ensures that our programs are inclusive of all veterans, regardless of their branch of service. All responses are confidential and will be used to enhance our services and support for veterans in the community.
Disability Status
Collecting information about disability status is crucial for the New York Peer Specialist Certification Board (NYPSCB) to advocate for environments that are truly inclusive and supportive of all peer specialists. Understanding the prevalence and types of disabilities within the workforce allows NYPSCB to design and implement measures that meet diverse needs effectively.
Do you have a disability?
Yes
No
Prefer not to answer
If yes, what kind of disability?
Neurodiverse
Autistic
Physical (e.g., mobility issues, chronic pain, limited dexterity)
Mental Health (e.g., anxiety, depression, PTSD)
Intellectual/Developmental (e.g., autism, Down syndrome, learning disabilities)
Sensory (e.g., Blind, DeafBlind, Deaf, Low Vision, Hard of Hearing)
Other
Language and Communication Skills
The New York Peer Specialist Certification Board (NYPSCB) collects information about language and communication skills to ensure our workforce can effectively meet the needs of diverse communities. This data helps us identify multilingual peer specialists who can provide culturally and linguistically appropriate support, enhancing accessibility for individuals with limited English proficiency. Understanding language skills also allows us to target training and deployment of peer specialists in areas where specific language capabilities are in high demand, ultimately improving the quality and inclusivity of our services.
Primary Language Spoken at Home
English
Spanish
Chinese (Mandarin, Cantonese)
French
French Creole/Haitian Creole
Arabic
Russian
Korean
Italian
Bengali
Hindi
Urdu
Tagalog
Vietnamese
Polish
Portuguese
Greek
German
Japanese
Persian (Farsi)
Hebrew
Somali
Swahili
Punjabi
Turkish
Gujarati
Tamil
Amharic
Yoruba
Nepali
Ukrainian
Thai
Pashto
Bosnian
Serbian
Croatian
Khmer (Cambodian)
Dutch
Armenian
Malay/Indonesian
Hebrew
Hmong
Sinhala
Tigrinya
Albanian
Kurdish
Romanian
Czech
Bulgarian
Malayalam
Other
Collecting data on the primary and other languages spoken provides insight into the language capabilities of the peer workforce. This is critical for ensuring that services are accessible to individuals from diverse linguistic backgrounds. For example, if there is a high number of peer specialists fluent in Spanish or another language, those specialists can be deployed to areas with higher populations of non-English speakers to provide culturally and linguistically appropriate services. Knowing the languages spoken also supports workforce planning for multilingual service provision, identifying gaps where additional language training might be needed, and ensuring that peer support services are equitable and inclusive. This data ultimately enhances the ability of peer specialists to engage effectively with different communities, especially those that have limited English proficiency.
If you needed a sign language interpreter, what language would you need interpreted?
ASL
English
Mandarin
Russian
Spanish
Other
Collecting data on the primary and other languages spoken provides insight into the language capabilities of the peer workforce. This is critical for ensuring that services are accessible to individuals from diverse linguistic backgrounds. For example, if there is a high number of peer specialists fluent in Spanish or another language, those specialists can be deployed to areas with higher populations of non-English speakers to provide culturally and linguistically appropriate services. Knowing the languages spoken also supports workforce planning for multilingual service provision, identifying gaps where additional language training might be needed, and ensuring that peer support services are equitable and inclusive. This data ultimately enhances the ability of peer specialists to engage effectively with different communities, especially those that have limited English proficiency.
Workforce Information
The New York Peer Specialist Certification Board (NYPSCB) collects information about the workforce to gain insights into employment trends, understand the composition of our certified peer specialist community, and identify gaps or opportunities for growth. By gathering information about your current employer, employment type, and role, we can better support career development, provide targeted resources, and advocate for the needs of our workforce. This data will remain confidential and be used solely for research, analysis, and workforce development purposes.
Current Employer
Employer Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ã…land Islands
Employment Start Date
MM slash DD slash YYYY
Employment Type
Full Time
Part Time
Per diem/As needed
Internship
Volunteer
Self Employed
Other
Role in the Organization
Provide a brief description of your role or title
Describe your employer and what it does.
Provide a brief description of what your employer does.
Is your position
Remote
Hybrid
In-person
Other
This information will help provide insight into where peer specialists are working and how they deliver their services (e.g., remotely or in-person).
Job Satisfaction
The New York Peer Specialist Certification Board (NYPSCB) collects information on job satisfaction to understand how well the needs of certified peer specialists are being met in their current roles. This data helps identify areas of strength as well as challenges affecting engagement, performance, and retention. By understanding job satisfaction levels, we can implement targeted improvements, provide appropriate support, and create a more positive work environment that enhances overall effectiveness and well-being for our workforce.
Have you had opportunities for career advancement in your current position?
Yes
No
Unsure
This information will help assess workforce morale and identify areas where additional support or opportunities are needed.
Have you been promoted since starting this role?
Yes
No
Prefer not to answer
Other
Are you currently serving in multiple roles within your organization?
Yes
No
If you had the opportunity to receive additional on the job training, would you take it?
Yes
No
If you could transfer to another position (and not be a peer), would you?
Yes
No
If you are serving in multiple roles, please describe your additional roles.
How would you describe your satisfaction with the pay and benefits you receive for your role as a peer specialist?
Very Dissatisfied
Dissatisfied
Neutral
Satisfied
Very Satisfied
What are the biggest challenges you face in your current role as a Certified Peer Specialist?
Inadequate compensation
Burnout and/or work-related stress
Limited opportunities for professional growth
Lack of supervision/support
High caseload
Lack of recognition
Difficulty navigating the system
Other
Do you feel that you receive adequate supervision and support from your supervisor?
Yes
No
Sometimes
Not applicable
Other
How would you describe your work-life balance?
Very poor
Poor
Neutral
Good
Excellent
How satisfied are you with your current job as a Certified Peer Specialist?
Very dissatisfied
Dissatisfied
Neutral
Satisfied
Very satisfied
Have you received any specialized training for your role as a peer specialist?
Trauma Informed Care
Crisis Intervention
Motivational Interviewing
Substance Use Recovery Support
Cultural Competency
I have not received any specialized support
Select All
Educational Background
Understanding the educational diversity of peer specialists allows the NYPSCB to tailor career development and training opportunities based on the existing qualifications of the workforce. By knowing the highest level of education attained, NYPSCB can identify potential skills gaps and design targeted interventions, such as additional certifications or specialized training programs. For instance, specialists with less formal education might benefit from foundational workshops, while those with advanced degrees may need leadership or advanced clinical skills training. Additionally, this information helps assess whether the workforce is representative of diverse educational backgrounds, which can inform outreach efforts to recruit individuals from underrepresented educational levels.
Highest Level of Education Completed
Did not complete High School
High school
GED/TASC
Associate's
Bachelor's
Master's
Doctorate
Technical/Professional Certification
Other
Understanding the educational diversity of peer specialists allows the NYPSCB to tailor career development and training opportunities based on the existing qualifications of the workforce. By knowing the highest level of education attained, NYPSCB can identify potential skills gaps and design targeted interventions, such as additional certifications or specialized training programs. For instance, specialists with less formal education might benefit from foundational workshops, while those with advanced degrees may need leadership or advanced clinical skills training. Additionally, this information helps assess whether the workforce is representative of diverse educational backgrounds, which can inform outreach efforts to recruit individuals from underrepresented educational levels.
Select additional peer certifications
National Certified Peer Specialist (NCPS)
Certified Recovery Peer Advocate (CRPA)
Youth Peer Advocate (NYS)
Family Peer Advocate (NYS)
NYS Certified Peer Worker in Pre-Exposure Prophylaxis (PrEP)
Independent Living Center Peer Advocate
Open Doors Peer Advocate
Select All