Virtual PME/PMDD Workshop
This group is for participants diagnosed with PME/PMDD. If you are looking for a group to support partners and families, please refer back to my website for the PME/PMDD Support Person Workshop!

Please answer all questions honestly. Your answers will help me better prepare for our group experience. There are a limited number of spots available in this group. If your application is not accepted I will send you an email giving more information about participating in the future. Thank you for considering participation in the Virtual PME/PMDD Workshop.
Email *
Name: *
Email: *
Phone: *
Address: *
Tell me a little bit about yourself: *
Why are you interested in participating in this group? *
What do you hope to learn about or gain from this group? *
Are you comfortable actively participating in the group? Will you be comfortable talking about your experiences of PME/PMDD as well as being open with the experiences of others? *
Will you be able to participate in all sessions? *
Is there anything else you feel I should know about you before accepting your application to this group? *
I give my consent for Ashley Barrett of Fern Therapy & Wellness, LLC to create a client profile for me and send me consent documents through their electronic health records system, SimplePractice? SimplePractice is a HIPAA compliant record keeping platform. My information will be encrypted and kept private unless I choose to share it.
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Thank you so much for applying for the Virtual PME/PMDD Workshop 2024 Cohort!
You will receive an email with information about group participation after the application end date of November 30, 2023.
A copy of your responses will be emailed to the address you provided.
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