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Pandemic Parent Support Group
Event Timing: Tuesdays at 8pm, September 8th – October 27th, 2020
Event Address: Google Meet
Contact us at (347) 560-4628 or
https://pleasantvillepsychologygroup.com/contact/
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Full Name
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Preferred pronouns
He/Him/His
She/Her/Hers
They/Them/Theirs
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Email Address
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Phone Number (best time of day to reach you)
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Age
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Profession
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Your answer
What best describes your current work situation?
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Stay at Home Parent
Working from home
Commuting
Furloughed
On leave
Laid off
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How many children in your household?
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Your answer
Grade levels of children?
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Preschool
K-2
3-4
5-8
Highschool
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School District
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Your answer
Schooling plan
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In school - Hybrid Model
In school - In Person
Remote Learning
Homeschooling
Undecided
What do you hope to get out of the group?
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Do you have any specific concerns you would like us to know?
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Thank you for your inquiry. Dr. Bly or Dr. Picheny will be in touch to confirm and finalize enrollment.
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