Affirming Hearts Academy: Healthy LGBTQ+ Relationships Group
Interest Form

This interest survey is for our cohort beginning June 18th, 2026. Thank you for your interest in Affirming Hearts Academy, Mazzoni Center's healthy relationships educational group for LGBTQ+ folks! Please fill out the survey below and we will be in contact soon.

This project was supported by 15JOVW-22-GG-00404-UNDE awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this document are those of the author and do not necessarily reflect the views of the U.S. Department of Justice, Office on Violence Against Women.
1.Please enter your contact information so we can reach out to you. We primarily communicate via Email.
We will not share this information.
(Required.)
2.Do you identify as LGBTQ+?
**This group is for folks that identify as LGBTQ+ or an identity under the LGBTQ+ umbrella**
(Required.)
3.Are you based in Philadelphia or the surrounding area?
**This group meets in person in Philadelphia**
(Required.)
4.Where did you hear about this group?(Required.)
5.Why are you interested in learning about healthy LGBTQ+ affirming relationships?(Required.)
6.What age range are you in?
We do not offer healthy relationships groups for folks 13 or younger at this time.

*If you are 18 and in high school, please choose the first option. If you are 18 and out of high school, please choose the second option.
(Required.)
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