Book A Therapy Group - Your Menopause Therapist

To be considered for a group please fill out the application below.

Name

Date of Birth

Phone Number

Full address

Any physical or mental health diagnoses?

Have you ever received counselling or therapy before?

Did you find it helpful/not helpful? Why?

Which group(s) would you like to be considered for?

How did you hear about the groups?

What do you hope to gain from coming to the group?

How comfortable are you in groups generally? What role do you usually play?

Have you ever attempted to take your own life?

Are you currently experiencing any suicidal ideation or suicidal thoughts?