My Own Muse
A few questions to get to know you, help you set your intentions, and to acknowledge the purpose for the group.
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Email *
A therapy group curated to be a source of support, encouragement, and mental health education as  you explore what being a black creative or artist means to you. What drives you? What makes you stand apart? What scares you as you move further along your journey?
Full Name *
Age *
Birthday *
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Current Location *
What is your creative medium(s) or outlet(s)? *
How long have you been creating? *
What or who originally inspired you to create? *
What are two things about being a creative that you love? *
What is an area of being a creative that you struggle with? *
Are you an artist who creates in hopes of sharing your work/creations in public spaces or do you solely create for self? *
What does being a black creative mean to you? *
What is your history with and understanding of your mental health? *
What concerns do you have about being a part of this therapy group, if any? *
Personal Intention Statement: I am committed to doing my best to grow into someone who shows myself more kindness, compassion, patience, positivity, and love. I believe that I deserve great things and that I have the ability to mold the future that I desire. *
Required
Group Acknowledgment: I acknowledge that there is a confidentiality agreement between myself, the therapist, and everyone else involved in the group. Everything that is discussed within the group sessions will remain within the group sessions. Please fill in your name (first and last) to represent your acknowledgement and signature for the above statement. *
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