The Sanctuary Interest Survey
Objective : The Sanctuary is an open-ended self-help group led by professionals and non-professionals knowledgeable in various subject matters as well as peer-lead discussions. Our goal is to establish a safe space that encourages community, transparency, and empowerment of individuality, thought, and expression through group discussions and other activities utilizing peer interaction for healing and recovery.
Dislcoure: Particpation in these discussion are not substitiuest to additonal help if needed.
Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
Email
*
example@example.com
Age
Under 18
18-24
Gender
Male
Female
Non-binary
Prefer not to say
Topics of Interest (Check all that apply)
Anxiety
Depression
Stress Management
Relationship Issues
Grief and Loss
Self-Esteem
Trauma Recovery
Addiction Recovery
Anger Management
Life Transitions
Preferred Time for Group Sessions
Morning
Afternoon
Evening
Weekends
Goals and Expectations:
What are your goals for participating in group therapy?
What do you hope to gain from the group experience?
Is there anything specific you would like the facilitator to know about your preferences or needs in a group setting?
Submit
Should be Empty: