Your Asian American Journey: What is your story?

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All information is strictly confidential. This group is open only to New York State residents. The below questions will help the group counselor understand the needs of the group and of each participant. It will also allow the staff to discern if this group experience is a good fit with your counseling needs at this moment. Lastly, it allows potential participants to review and to commit to the policies for group membership and the guidelines for group meetings.

The group will be held Wednesdays beginning April 10. All sessions will be held at the Redeemer Counseling offices.

Time: Wednesdays, 6:30 - 8:00 PM

Email *

Name: *

Date of Birth: *

Phone Number: *

Email Address: *

Marital Status: *

Single

Engaged

Married

Separated

Divorced

If you have children, please list how many and their ages:

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