Group Therapy Intake Form - Adults Full Name * First Name Last Name Email * Date of Birth * Rate * $30 $40 $60 Group * Adult CBT Group: Addressing Depression and Anxiety Processing Group for Individuals Who Have Failed Post-Graduate Exams Availability * Please provide five dates and times that you are available for a virtual or in-person intake appointment: Important Information * All intake sessions are 30 minutes in length. There is a non-refundable fee of $45 for the intake session. Please note that participation in the group is not guaranteed after the intake session. If it is determined that the group is not a suitable fit, we will provide appropriate referrals to other services or resources. I understand and agree to the terms. Thank you!
