15-Minute Mindfulness Check-In Registration Request Survey

JFS is offering FREE 15-minute Mindfulness Check-In via Zoom Conference Calls on every Tuesday at 9am to practice different mindfulness exercises to regulate the impacts of election related anxiety and stress on our behavioral and mental health well-being.

These Check-Ins are designed to provide a safe and supportive virtual environment for participants to learn how to breathe, meditate, relax and self-sooth to promote our psychological health during this stressful time. All Check-Ins are being facilitated by a rotation of licensed clinicians or master’s level clinical intern students under supervision through a HIPAA compliant Zoom system.

Please note that registration is required before joining the Check-Ins for security reasons, and the session will be closed after 5 minutes of the start time.

If you would prefer to have individual or group therapy/ counseling sessions instead of a brief Mindfulness Check-In, you may make appointments for therapy/counseling (by phone or online) by filling out our online form link provided at the end of this registration.

15-Minute Mindfulness Check-In Registration Request

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* 1. What is your name?

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* 2. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)

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* 3. What is your phone number?

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* 4. What is your email address?

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* 5. Are you a current JFS client?

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* 6. What is your age?

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* 7. I understand that the purpose of the check-in session is limited to mindfulness practices and is not considered mental health counseling or therapy.

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* 8. A representative of JFS will contact you and provide you the Zoom information. Please let us know your preferred method of contact?

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* 9. I understand that there will be no recording of any of the online sessions by either party.

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* 10. I understand that using telemental health services using Zoom could encounter technical difficulties resulting in service interruptions.

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* 11. Would you be interested in learning more about other zoom support groups JFS offers?

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* 12. Would you be willing to complete a brief survey after your Check-In session to get a better understanding of how this experience was for you? The survey will be sent to the email you provided for registration.

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* 13. I am aware that if I am experiencing a life-threatening emergency, I will call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

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* 14. JFS also provides individual or group therapy sessions via telemental health services using Zoom. Would you be interested in learning more about scheduling time with a clinician?