CPRT Group

This registration is for the CPRT Group. This 10 week in-person group is open to parents with children of ages 2-10. One no charge 15-minute call is required before the group begins.

Dates:	10 consectutive weeks from September 8, 2021 to November 10, 2021. 10AM - 12 PM
Where:	Center for Relational Care 11615 Angus Rd., Suite 218 Austin, TX 78759
Cost:	$400 per individual ($40/ session). $600 per couple

Please describe your situation.

I am a single parent or guardian I am parenting with a spouse or partner

Parent or Guardian Name *

First Name Last Name

Parent or Guardian Phone Number *

Please enter a valid phone number.

Parent or Guardian Email *

example@example.com

Second Parent or Guardian Name *

First Name Last Name

Second Parent or Guardian Phone Number *

Please enter a valid phone number.

Second Parent or Guardian Email *

example@example.com

Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Please list the age of each of your children and if they are adopted or biological children. *

For CPRT, one child of focus will be chosen for each individual attending the group. Please share your biggest challenge with parenting this child? *

What is the biggest joy you have experienced with parenting your child? *

What are your parenting strengths? *

What are your areas of growth in parenting? *

Has there been any trauma or crisis experienced for your child? *

Yes No

Please describe the the traumatic event or crisis. *

What made you interested in this group? *

If the group transitioned to a virtual platform based on COVID numbers and CDC guidelines, would you still be interested in participating? *

Yes No

Thank you registering for the CPRT Group! Registration is not finalized until you complete the 15 minute call. Audra Niedzielski, LPC, RPT, PMH-C will contact you within 5 business days in regards to scheduling the intake session. If you have any questions or need assistance, please contact our office at 512-492-6200.

Child - Parent Relationship Therapy (CRPT) Training Group