Basic Life Skills Registration
FJ Psychological Services has developed a Basic Life Skills Group that was designed to foster the learning and application of novel skills. The weekly lessons cover three main themes: self-awareness, interpersonal skills, and thinking skills. The lessons last about 90 minutes and can be tailored for any age between 8-24 year olds. While this is a new program, all of the lessons are founded on evidence-based psychosocial methodology, including cognitive behavioral therapy, mindfulness and resistance-building activities. We will be advertising the weekly topics on our social media pages, so be sure to follow us to know what to expect each week. It is recommended you attend every session, but if you are unable we understand. We are asking that those interested complete this survey, so we can divide interested people into age-matched groups and begin scheduling these sessions.
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Are you an existing client at FJ Psychological Services? *
What is the full name of the person you are registering? (If more than one, please write all of the names) *
If you are the guardian of the registered person, what is your name?
What is the registered persons date of birth? (If more than one, please write all of the birthdays) *
What is your email address? *
What is your phone number? *
If you have insurance, what is your insurance carrier?
Does the registered person(s) have any allergies or medical concerns we should be aware of? *
If you are registering your child, are they potty trained? 
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When would you like the program to begin? *
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Do Thursdays at 5pm work for you?
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Each session will be $25 upfront, but most insurance companies will reimburse you. If you don't have insurance or your plan does not cover group therapy, we offer a sliding scale payment option. Please mark below how much you will be able to pay upfront each week. *
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