Interested in joining this group and/or learning more? Please complete the below information and we will reach out to you shortly. Child's Full Name Age School Grade 7th 8th Parent/Guardian's Full Name Parent/Guardian E-mail Phone Preferred method of contact Phone E-mail No preference Briefly describe any primary concerns your child is experiencing: Please list any current or suspected mental health diagnoses (e.g., Anxiety; Depression; ADHD; Learning Differences, etc.) Is your child currently in individual therapy? Yes No If so, are you comfortable sharing with your child's therapist the fact that she may participate in this therapy group? Yes No Not applicable What would you and/or your child hope to get out of this group? Is there any additional information you'd like to share with us? Do you have a preference as to whether this group meets in-person vs. virtually? In-person Virtual Undecided No preference How did you learn of this group? Submit Share this:Click to email a link to a friend (Opens in new window)