Therapist Led Support Group Interest Form
Therapist Led Transgender Support Group Interest Form
Sign in to Google to save your progress. Learn more
Email *
What is your name? *
How do you describe your gender identity? *
We plan to hold this group 2nd Wednesdays of the month from 6pm-7:30pm for 6 months, Jan-June 2021. Will those times work for you or do you have alternate suggestions? *
What are your needs and expectations for transgender group therapy? *
We expect to charge $5-$25 per monthly session (you decide which amount). Will this be a burden to you financially? *
Do you have any other questions?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of The Gala Pride and Diversity Center. Report Abuse