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Lost a parent(s)? Join my grief support group
Congratulations on taking the first step towards building your inner peace. I just have a few questions to ask before we get started. Tell me a little bit about yourself.
12
Questions
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1
"As I walked out the door toward the gate that would lead to my freedom. I knew if I didn't leave my hatred behind, I'd still be in prison." ~ Nelson Mandela
Let's get started!
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2
How did you hear about our grief support group?
Word of Mouth
TikTok
Instagram
Twitter
YouTube
Newsletter
Other
Other
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3
Name
*
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First Name
Last Name
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4
Email
example@example.com
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5
What is the best way to reach you (email or SMS)
SMS(please include your phone number )
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6
Which day of the week works best for you to meet up?
Monday, Tuesday, Wednesday, etc
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7
What time of day works best?
Please be in mind your host, is in Eastern Standard Time
Morning
Night
Noon
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8
Do you prefer we meet for our grief support group LIVE or in a private zoom call?
*
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9
Do you listen to the Argh U Mad Podcast?
Yes on YouTube
I've listened to a few shows through audio lie spotify and or apple podcast
No I havent
No this is my first time seeing you
Other
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10
What do you hope to benefit or gain from our grief support group?
*
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I.E. ( a deeper understanding of myself, how to work with people, i don't know yet)
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11
I am not a license mental health professional. Is that ok?
I do have professional experience with serving the public as a mental health case manager and I have completed my undergraduate studies in psychology, plus more personal and professional experience.
YES
NO
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12
Are you ok with being photographed and or video clips of our group support for promotional purposes?
If no it's ok, I ask that you leave your camera off if we meet via zoom
YES
NO
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13
Invoice ID
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14
Terms and Conditions
*
This field is required.
I give Argh U Mad LLC consent to use portions of our session for promotional purposes. I agree and understand the reason for taking part in the content helps in building the community of MadHatters. Please email arghumad@gmail.com with any questions pertaining to our grief support group terms.
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