Trauma-based Support Group Questionnaire

Although a psychologist can best provide treatment for you, it can also help to join a support group in addition to your clinical treatment. For some people, a support group is a good place to begin getting help.

YOUR INFORMATION

First name*

Last name*

Email*

Phone*

Your Pronouns*

Age*

I agree to terms and agreements.

Have you experienced significant trauma, and/or have you been diagnosed with PTSD or cPTSD?*

Are you suffering from internalized transphobia?

What is your ethnicity? (We are only asking this to possibly match you with our specific group for black queers and POC)

Have you experienced racism? (We are only asking this to possibly match you with our specific group for black queers and POC)

Do you have access to wifi and the application “ZOOM” (for online video sessions)?

Please note that the support groups are facilitated in English. Each group is lead by an experienced certified counselor/therapist. However, the groups have a peer group approach and do not substitute individual therapy.

By submitting you agreeing to our terms and agreements.
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Trauma-based Support Group Questionnaire

YOUR INFORMATION

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