Anxiety Workshop Registration
Your Safe Space presents a 3 week anxiety workshop.  Complete this form  to join our first June cohort.  Upon registration you will receive the virtual meeting link via email.  Details for the June cohort are shared below.  

Date(s): Session 1- Wednesday June 7th, 2023; Session 2-June 14th, 2023; Session 3-June 21st, 2023
Time: 7:30 PM - 8:45 PM
Location: Virtual via Google Meets (the link to access all sessions will be shared upon submission of the registration form below)
Cost: Registration is free.  The group session fee can be covered by your insurance.  If you choose to pay out of pocket we will reduce the out of pocket cost to $55.00 per session. 
Contact us at: (301) 459-0708 or  Admin@YourSafeSpace.org

Thank you for your participation.
Email *
First Name *
Last Name
Date of Birth *
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Age
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Email *
Form of payment *
Phone (home or mobile ) *
Insurances accepted *
Insurance Number
Policy Holders Full Name and Date of Birth (for authorization purposes) Medicaid does not require adult policy holder information.
Have you ever blacked out/had memory lapse/passed out/ experienced an out of body experience from anxiety or any other situation? *
Please let us know if you need time with the YSS staff before the group begins to reduce your feelings, thoughts, or concerns pertaining to anxiety.  If so, please provide the attendee contact information.  *
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