Group registration
Self-Care Monday's - Anxiety Support Group
Time: Every Monday at 6pm / 1pm (college students), 4pm in person (Victorville)- All times are PST : California
Location : Virtual meeting at GOOGLEMEET 
Contact Group Facilitator at groupsrus21@gamil.com for additional questions 

Groups are a place for connection, information and healing but are not meant to be a replacement for medical care, psychiatric or psychotherapy. Please consult with your provider, care team or therapist for treatment needs

The information shared is for admission purpose only and to help determine if you are a good fit for the group. 
Email *
Name *
Email *
Are you struggling with finding helpful tools for managing your stress and anxiety?  *
Are you currently working with a therapist for individual treatment?
Clear selection
What time will you attend Monday's group? *
Required
How did you hear about the Group? *
Payment *
I agree to receive weekly email reminders about the group and information about agency workshops or packages in future communications. *
Required

CONSENT

I agree to adhere to the norms and expectations for group therapy as indicated in the consent form provided below. I acknowledge that I have had the opportunity to ask questions and such questions were answered clearly and to my satisfaction. Consent Form

 *
A copy of your responses will be emailed to .
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
Google Forms