HOPE Group Therapy Waitlist
This survey will help determine the types of groups we may offer at HOPE, please provide as much detail as possible by the end of the survey. If you have any further questions or concerns after filling out the survey please email admin@hopepsychiatry.com
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Email *
What is your name? *
Age *
What is your contact information (Provide email and phone number) *
What type of group are you looking for? (Check all that apply) *
Required
If there was a same sex process group which one would you like to attend? (check all that apply) *
Required
How long do you want the group to meet for?  *
Required
How often are you looking for the group to meet? (Check all that apply) *
Required
Are you looking for a virtual or in person group (in person groups would be only be at our Sherman Oaks or Mill Valley office) *
Required
Would you be interested in Ketamine Assisted Group Therapy? *
Please provide any further information or description of the type of group you would like to participate in?  *
What are the types of issues you would like to address in group therapy? *
A copy of your responses will be emailed to the address you provided.
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