TACT | Peer Group Consent
Thank you for your interest in joining a peer support group! Please complete the following questions and read the informed consent policies outlined below.

After you complete this information, we will email you with next steps and a zoom link to join a support group. 
Sign in to Google to save your progress. Learn more
First Name (Affirming/Chosen Name) *
Last Name *
Pronouns *
Email Address *
Phone *
Age *
City *
State *
How would you describe your residential area? *
Which race or ethnicity best describes you? *
Select all that apply.
Required
Which Peer Support Group are you interested in joining?
Our Peer Support Groups have a limited capacity. If you select more than one option, it is more likely that we will be able to place you in a group more quickly. You can always request to be put on the waiting list for another group once it becomes available. 

If you are only interested in one of our groups, only select an answer for "first choice."
Nonbinary Support Group
POC Nonbinary Support Group
Neurodivergent Trans Support Group
Trans Masculine Support Group (join the waitlist—not currently running)
Trans Feminine Support Group (join the waitlist—not currently running)
First choice
Second choice
Third choice
Clear selection
Do you identify as disabled and/or neurodivergent? *
We strive to make our peer group spaces as accessible and welcoming as possible. Do you have any accommodation or accessibility requests that would help you access or feel more comfortable in the space?
Are there any other support groups that you would like to see offered in the future?
How did you hear about us? *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of TACT. Report Abuse
Google Forms