Healing from Collective Trauma Community Group
Please read carefully our information regarding our free peer support group before filling out this form:

Disclaimer: This is a peer support group for community members, not a therapy group.  If you are looking for a therapy group or individual therapy services, please contact our Intake Coordinator, Lewis Johnson, at (484) 440-9416 or support@phoenixtraumacenter.com

Tuesdays 5:30- 7:00 PM via Zoom (beginning on Tuesday, January 10, 2022 )

This is a virtual community support group via Zoom. The link will be provided after registration.

Please fill out this form by November 10, 2022. One of our clinicians will contact you to follow up.

Rules, Norms, and Commitments:

· Confidentiality and Privacy— We agree not to talk about other participants’ sharing outside of the group.

· Respect– We agree to respect everyone in the group for who they are, for how they identify, and for what they have experienced regardless of their beliefs or opinions

· Self-Care— We agree to prioritize our self-care, taking care of ourselves and asking for additional support if needed

· Sharing— We agree to respect each other's sharing.

· Peer Support— We agree to contribute to supporting each other when possible

· Choice— We understand that we can choose how much or how little we want to disclose in the group based on our comfort level
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电子邮件地址 *
Full Name *
Email Address *
Gender & Preferred Pronouns
*
Phone Number
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What other identities would you like us to know about at this time? (race, ethnicity, SES, immigration, etc.)  
Have you been a client of or attended a community group with the Phoenix Center for Experiential Trauma Therapy previously, either in-person or online?
*
What brings you to this group at this time? What are your hopes for your time in this group?
*
What supports do you have outside of this group?
*
By submitting this form, I affirm all of the following: 
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