Please fill this out to start the discussion with Kellie about whether Group is right for you. Name * First Name Last Name Pronouns Age * Phone * (###) ### #### Email * How did you hear about this Group? * What is your experience with group work? * How do you support yourself--financially, emotionally, mentally? * Describe any previous experience with Personal Growth Work (eg: 1:1 therapy or coaching, support groups, etc.) * Please describe your physical health, including any chronic issues * Do you have a mental health diagnosis? If so, what is it and how is it managed? * Thank you! Kellie will reach out to you shortly.
