Therapist Support Circle Inquiry Form

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This field is for validation purposes and should be left unchanged.
Please indicate how you’d like me to respond to this inquiry
Date of Birth*
What is your preferred group meeting time?*
Both groups occur on a biweekly basis.
Group payment structure*
The group is $20 a meeting with a minimum 8 meeting commitment that will be charged in one lump sum of $160 unless otherwise agreed upon by you and the group leader. However, if you would like to try one meeting before committing you can do so. You will be charged $20 for the first meeting and the subsequent $160 if you decide to continue. After 8 meetings, you are welcome and encouraged to continue attending and will be charged per meeting. By checking “Yes” below, you will indicate that you have read and agreed to the group pay structure.
Would you like to have a 10 min phone consultation with the group leader before signing up?*
You are welcome to request a call, but it is not mandatory. The group leader may also reach out to talk with you before joining the group to determine goodness of fit.