Bryon Remo, M.Ed., LMFT

This survey is designed to gain some general background on each participant and gather an understanding of what you are looking to address during the group.

Identiying Information

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* 1. Identiying Information

Which response best depicts where you are in the divorce process

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* 2. Which response best depicts where you are in the divorce process

Are you currently seeing an individual therapist?

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* 4. Are you currently seeing an individual therapist?

Check the Level of Importance to You  for Each Issue

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* 5. Check the Level of Importance to You  for Each Issue

  Very Important Important Not That Important Not Applicable
Logistics of Divorce, Mediation & Litigation
Financial Concerns
Suspected Verbal, Physical or Sexual Abuse by the Other Parent
Parenting in Two Homes & Setting Boundaries
How to Navigate Extended Family Life
Self-care and Re-Inventing Myself
Meeting New People, Blended Family Challenges
Concerns About Communication (cell phones, social media, etc)
Is there anything not mentioned you would like to have discussed? Or anything else you would like me to know before the group commences?

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* 6. Is there anything not mentioned you would like to have discussed? Or anything else you would like me to know before the group commences?

What are your favorite snack foods?

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* 7. What are your favorite snack foods?

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