Group Therapy sign up 
Thank you for your interest in joining group therapy at It's Time.  In order to secure your place please complete the form below.

There are 3 groups a year starting in January, April and September and lasting for 10 weeks.  The sessions will be held on a Thursday evening on Zoom from 7.30pm - 8.45pm. There is no charge for the therapy.  

People taking part must have lost a parent, live in the UK and be between 18 - 30 years old.  

In order to ensure you and the group as a whole are able to benefit fully from the group therapy we also ask that you are in a position to commit to the full 10 weeks and that you are ready to participate in the group fully.  As mentioned above the groups are run 3 times a year starting in January, April and September so if it would be more convenient for you to join a specific group (eg April) please say in the any further comments section at the end of the form.

The sessions will be run by a clinician who adheres to UKCP guidelines and the group will be run under these regulations.  For full details see the UKCP website: www.psychotherapy.org.uk 

We won't share the information provided below with anyone outside of the It's Time group therapy service team and will only use it in relation to your use of this service and any other areas of It's Time's work you choose to become involved in.  Should you wish to change or delete any of the information provided at any time please do contact us at hello@itstimecharity.co.uk

If you have any questions about the group therapy service, the form below or how your data will be used please contact our Operations and Fundraising Manager Katrina Alcock:  katrinaa@itstimecharity.co.uk  or 07723 288 527.

It's Time understands your privacy is important. We will treat your information in accordance with the General Data Protection Regulations (GDPR) and in accordance with the Data Protection Act 1998. 

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First name *
Last name *
Email address *
Mobile number *
Postal Address *
Please indicate where you are currently living *
What's your date of birth? *
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What is your current age? *
Preferred pronouns
 *
Gender *
If you have lost a parent how old were you when it happened? *
Required
Please indicate whether the parent who has died is your mother, father or both parents *
And what was the cause of death? *
Why would you like to take part in group therapy with It's Time? *
Do you have any significant health issues?   If so please let us know of any reasonable adjustments you may require in order to take part in an online group. *
Do you have any disabilities and / or additional needs that we need to be aware of? If so please let us know of any reasonable adjustments you may require in order to take part in an online group.
 *
Are you currently in therapy? *
Required
Any further details about your current / past therapy (optional)

Please tick any mental health and / or issues you may struggle with:
How did you hear about the service

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If you chose 'other' or 'other support services' please give further details below
Please indicate your ethnic origin; your ethnic origin is the group that you perceive you belong to. Please tick the box which you feel most accurately reflects this.   *
Required
Signature *
Date *
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YYYY
We'd love to keep you informed about ways to get more involved - please select the areas you are interested in below. 

We promise not to spam and will send a maximum of one email a month. If you would like to be removed from our mailing list at any time please email us at hello@itstimecharity.co.uk
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