Sister Circle Intake Questionnaire

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This is our initial questionnaire to begin your time with Sister Circle. The first section (questions 1 - 7) will need to be completed with your daughter. We will refer to our program participants as "Sister" throughout the content of this form and our program to help engage the feeling of relationship.

The following section (questions 8 - 15) is for the parent(s)/guardian(s) to complete.

All information listed in this form is kept confidential and only shared among the directors and facilitators of Sister Circle with Fourfold Sisterhood.

Email *

1. Sister's full name (legal first & last name)?
*

2. Any nicknames or alternatives that you (our new Sister) prefer to be called? *

3. Sister's Age?
*

4. Sister's birth date?
*

YYYY

5. Sister's phone number (if applicable, enter "N/A" if none)?
*

6. Any important physical or mental health information that you (our new Sister) want to share to help us create a safe space for you? *

7. What are you (our new Sister) wanting to gain from joining Sister Circle?
*

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