LGBTQ Group Interest Form
Corner Health Center
Please fill out this form if you are interested in joining our LGBTQ Group!
Corner Health Center's LGBTQ Support Group is a group for queer, transgender, and questioning young adults. The group provides an accepting and inclusive space for participants to find support and make connections with others. Participant interests direct the discussion. Group is not a substitute for individual therapy. Group meets virtually, Friday afternoons from 2-3 pm starting October 10th. Group enrollment is ongoing.
Participant Name
First Name
Last Name
Participant Pronouns
Participant Age (must be 18-25)
Phone Number
Please enter a valid phone number.
Alternate Phone Number
Email
example@example.com
Are you currently receiving services from Corner Health? If so, please describe.
Have you participated in any support group before? If so, please describe.
List things you are hoping to get out of this group:
List any concerns you have about participating in group:
Any other information you want us to know?
Thank you!
Contact group facilitator Brynne Garver at bgarver@cornerhealth.org with any questions. The facilitator will reach out before group starts to discuss group expectations.
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