Group Therapy Interest Form - Healing Studio
Dear Seeker,

Please fill the form if you are seeking to join group therapy or support groups at Healing Studio. The group therapy and support groups are for adults who experience anxiety, depression, loss or any interpersonal or psychological issue.

Please note that we can't accommodate all the request that we receive, we only have 8 spots per group and can accommodate you only if there is any space currently available or when the old members leave due to some reason and we open the group for new members to join.

The online groups will be hosted on zoom and you will need a safe private space and be required to be visible to each other during the group session (with your camera and mic switched on).

After you fill the form, please drop a whatsapp message on +91 7021440454. We will share the details about timings, fees etc.

Tejas Shah
Mental Health Professional,
M.Phil Clinical Psychology (RCI),
Clinical Director, Healing Studio.
www.healingstudio.in
tejas.psy@gmail.com
(+91) 702 144 0454
Sign in to Google to save your progress. Learn more
Email *
Name *
Phone number *
Age *
Gender *
Relationship Status *
Educational qualification (degree, institute, year) *
Occupation (role, industry, organisation, no. of years) *
Address (full postal address) *
Emergency contact (name, number and relationship) *
Compulsory to mention name, number and relationship. This contact is needed in case of emergencies.
From where did you here about us? Details about who referred *
What time slots and days are good for you for Support Groups? think of few options (Mon to Fri - 9am to 10pm).. *
What days are good for you? think of few options (Mon to Fri - 9am to 11pm).. *
Required
What timings are good for you? think of few options (Mon to Fri - 9am to 11pm).. *
Required
What format are you okay with? Online, Offline, or Any *
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy