JOIN A GROUP QUESTIONAIRE | pacificmftnetwork

JOIN A GROUP

Support and Process Groups

Feel included and supported
Be with people that understand you
Have a safe space to be yourself
Convenience- from your home or office
Less expensive than other therapy

First Name

Last Name

Email Address

Phone

Age

Groups I am interested in

Co-ocurring Disorders - Depression, Anxiety, ADD/ADHD, PTSD, Bi-Polar, OCD, Disordered Eating, Social Isolation, Relational Issues

Trauma - Rejection/Love/Death, Neglect/Emotional Abuse, Attachment Issues ,Self-Injury ,Natural Disasters, Accidents/Surgery, Intimate Partner Violence, Relinquishment and Adoption

Additction- Substances, Pornography, Video Gaming, Gambling, Sex and Love, Internet, Compulsive Disorders

Please list days of the week and times you can attend group?

How much can you invest in therapy? Typical fees are $40-$60

Thank you for your interest in one of our groups. We will be in touch with you within 48 hours to discuss details.

Empowering You to Live the Life You Want

310-612-2998

CALL OR TEXT NOW

Pacific Marriage & Family Therapy Network

JOIN A GROUP

Support and Process Groups

Feel included and supported

Be with people that understand you

Have a safe space to be yourself

Convenience- from your home or office

Less expensive than other therapy