1.Are you interested in participating in a free group therapy option for support after the Central Texas floods?

Yes

No

2.Are you interested for you as an adult, for your child, or both?

Adult (self)

Child/Children

Both

3.What is the age of your child (if applicable)?

4-6 years old

6-9 years old

9-12 years old

12-15 years old

15-18 years old

4.What do you feel you are needing most?

Safe space to process emotions with loving community (process based)

Space to learn more about how to support self and/or children (education based)

Both

5.What time of the day are you or is your child available to participate in the group?

Morning time (9am-12pm)

Afternoon (12pm-4pm)

Evening (4pm-6pm)

6.Do you consent to being sent information about the group(s) should we move forward with this group option?

Yes

No

7.What is your email address?