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* 1. Please enter your full name

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* 3. Please enter your phone number

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* 4. Please enter your address

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* 5. How did you hear about the Sound Mind Therapy Holiday Grief Group?

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* 6. Have you attended a grief support group before?

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* 7. What are you hoping to gain from attending this support group?

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* 8. Would you like to receive email updates about future support groups or events?

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* 9. Are you committed to attending all 6 sessions?

The cost of the group is $200 for the entire 6 weeks.

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