Creative Art & Expression for Seniors Interest Form

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Creative Art & Expression is an in-person group for adults over the age of 55. The goal is to offer opportunities for building connections with peers, improving mental health and mood, and to provide a space to discuss mental health concerns including anxiety, depression, and grief.

This group meets at DeKalb Club 55 (330 Grove St. DeKalb, IL) every Tuesday 12:00pm-1:00pm.

For more information, please contact Family Service Agency (815)758-8616.

After completing this form, please allow up to one week for the designated clinician to contact you with upcoming dates and enrollment information.

Creative Art & Expression Flyer

What's Your Name? *

What's Your Age & Date of Birth? *

What's Your Phone Number? *

What's your email address?

What's Your Address? *

What's Your Preferred Mode of Transportation? *

I own a vehicle.

A friend, family member, or caregiver gives me rides.

I use public transportation (ex: Huskie Line, TransVac, etc.)

I don't have transportation.

Other:

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