THRIVE

THRIVE

Teen Process Group
EVERY WEDNESDAY, 5:30-7:00 PM

THRIVE is an ongoing process group at KCC which runs weekly on Wednesday nights. This group offers teens mutual support, self-awareness, interpersonal skills, and identity development. Teens aged 13-18 are welcome.

This group is billable to insurance. We are in-network with BCBS, Cigna, United, and limited Medicaid plans. If you choose not to use insurance, the fee is $40 per group session.
Name of teen

First NameLast Name
Preferred Pronouns
Are you a former or current KCC client?
Client Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Client Email
example@example.com
Client Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Name

First NameLast Name
Parent/Guardian Email
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

In order to join THRIVE, you must attend an orientation session with our group leader. You may be required to pull your teen out of school depending on availability. Please SELECT all times you would be available to schedule this meeting:?

Rows	10 AM	11 AM	12 PM	2 PM	3 PM	4 PM	5 PM
Monday
Tuesday
Wednesday
Thursday

Is there anyone your teen would be uncomfortable being in group with? Please provide their name(s).
Is there anything you want our group leaders to know before the first group session?
Contact Genevieve Stafford, our Group Coordinator, with any questions.

Genevieve@kernersvillecounseling.com

336-283-3830
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