APPLICATION: Infertility - Now, What?
This 6-week online/virtual group is confidential and for women (residing in Louisiana or Texas) who are on their fertility journey and discover real obstacles along the way.  Unfortunately and commonly, many women feel isolated, lonely, hopeful, confused, frustrated and filled with grief while desiring to expand their families through conventional methods, but face real challenges.  This group's purpose is not only to educate women, but to offer a unique experience of community and support when far too often, their needs are ignored.  

The cost of the group is $650 for the 6-weeks.  Payments in full for the group are made for the entire session via a payment link provided to you.  Participants will receive a video link to participate in the group after full payment is made.  If participants cannot attend one week, they will gain access to a video recording of the session.  

If this group is for you, please complete this application and share what would benefit you most while participating.  Your answers are confidential and help to maximize your experience over the course of the 6-week group.  

Once invited to participate, women meet weekly online through a private virtual platform.  Your confidentiality is of the utmost importance.  Also, ongoing weekly attendance enables connection with the full experience of talking with and to other Women from different backgrounds and life experiences. 
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First & Last Name: *
Phone Number: *
Email:  *
City & State of Residence: *
Current occupation (if working outside of home):  *
Self-Employed *
Work from Home? (does include stay-at-home) *
If your work situation is unique, please describe below:
Relationship status: *
If Other, please describe:
What has been your unique fertility experience? Describe below. *
Have you experienced the following? (check all that apply) *
Required
Any children in the home with you? *
Age range of child(ren) if residing in the home: *
Required
What led to your interest in joining this group? *
What areas do you find to be most challenging/stressful while on your fertility journey? (check all that apply) *
Required
If you also selected Other, please describe your experience:
What do you think you could add to a group like this one? *
At the end of the 6-week period, what do you hope to gain from your participation? *
Please keep in mind that each group consists of only 6 to 8 members - small enough for active and engaged conversations. Once you have completed this application, you will be contacted to set up an interview appointment and informed of the group's start date.  This interview helps to develop the cohesion of the group.  If you are not selected this time, but remain interested, let's discuss further about rolling your application to the next cohort.

I am so pleased that you want to connect with other women while on your unique journey and believe you can truly help to build a thriving community of people who support one another.

Thanks again,
Dr. Dana B. Labat
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