Group TherapyInterest Form Name * First Name Last Name Email * Phone * (###) ### #### Preferred Method Contact * Phone Email Date of Birth * Which group(s) are you interested in? (check all that apply) * Self-savvy Journaling SMondays Have you participated in therapy before? * Yes No Are you currently working with an individual therapist? * Yes No Do you have any mental health diagnoses? (If no, please list) * Do you consent to maintaining confidentiality and respect within the group? Yes No Thank you for your interest in group therapy! Your submission has been received. We will review your information and follow up with the next steps.
