Teen DBT Skills Group Interest 
Thank you for your interest in Hope Therapeutic Service's Dialectical Behavior Therapy (DBT) skills group. Dialectical behavior therapy is a form of therapy that supports skill building for managing intense emotions and navigating social relationships. This group offers a supportive space for Teens to learn communication skills, build connections, develop healthy ways to cope, and explore their overall sense of self.   This group is an In-Person 8-week session and is open to teens ages 13-17.  This is an on-going group based on individual needs and age groups, and meets weekly Wednesdays 4:30pm-5:30pm. This group has a maximum participant number of 6-8. Please identify below the group you are interested in.
Sign in to Google to save your progress. Learn more
Email *
Are you interested in attending our Teen DBT Group? *
Which group are you interested in attending?
Clear selection
Are you able to commit to most of or all of the 8 week group sessions? 
Clear selection
What is the name and age of the teen attending?
Please provide the following information:
Caregiver/Parent Name, Phone Number, Email, Best Time/Day to reach out
How did you hear about this event?
Clear selection
How would you like to pay for the group?
Clear selection
Please share your insurance information if you are seeking to use insurance benefits.
Please share any information that would help us to better care for your child.
Thank you very much for your interest! A  member of the Hope Team will contact you to explore your interest further. 
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy