Exit this survey

Drew's McClintock Center for Counseling and Psychotherapy will be running several confidential therapy and support groups this semester. If you are seeing a therapist at the Center speak to them about your interest in group. If not, please call to schedule an appointment to meet with the group leader before you attend a group.

* 1. Name

2. Email (if OK to email)

3. Preferred Phone

4. Cell provider (if OK to send text message to phone)

5. Check all groups you are interested in:

6. When are you available to attend group? (Please check all times you can possibly come to group, not just your preferred times.) Note there are some 1/2 hour slots in the late afternoon.

  Mon Tues Wed Thur Fri
9:00 am
10:00 am
11:00 am
12:00 pm
1:00 pm
2:00 pm
3:00 pm
3:30 pm
4:00 pm
4:30 pm
5:00 pm
5:30 pm
6:00 pm
7:00 pm

7. Anything else you want us to know about your availability (e.g. Let us know if you could come at a time but would be a few minutes late because of a class or work (we don't always have to start groups on the hour.)

8. Anything else you want us to know?

T