Starobin Counseling Support Group Application - Autistic Adults (Women, Female-identifying, and Non-Binary Autistic People)
Please complete the following form to share your interest in our support group for autistic adults who identify as female or non-binary. If you have any questions please contact sarah@starobincounseling.com.  Please note, we do not require a formal diagnosis to be part of the group.  Individuals who have self-identified are welcome to participate.
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Participant's name *
Participant's age *
Participant's email address *
Participants Phone Number (While we don’t require that you provide your phone number, adding it enables us to  communicate with you if email is not effective.  It also helps us stay organized in coordinating various group details).  
Participant's pronouns *
Participant's gender identity *
Participant's neurodevelopmental differences or diagnoses and age at diagnosis. *
Please briefly identify some of the concerns/challenges you face as an Autistic woman or non-binary person. *
What are some things you hope to get from participating in this group? *
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