Integrative Counseling Services' Circle of Security Female Caregiver Group
This group will either take place Integrative Counseling Services at 5 West Cayuga St. Oswego, NY 13126 and/or by Zoom (as needed). The group will take place from 11:30 AM - 1:00 PM on Tuesday October 7, 2025 and will continue through November 25, 2025. You must be able to attend all meetings in order to participate.
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
May we email you at this address?
*
Yes
No
Phone Number
*
Please enter a mobile phone number.
May we text you at this number?
*
Yes
No
May we leave voicemails at this number?
*
Yes
No
What insurance do you have?
*
E.g. Fidelis, Medicaid, Excellus Blue Cross Blue Shield, etc.
Insurance Card
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Choose a file
Please upload a picture of the front and back of your insurance card.
Cancel
of
Are you a parent/caregiver?
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Yes
No
If you answered yes, what age is your child/children?
*
Have you been in counseling before?
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Yes
No
What areas are you hoping to focus on the most in this group?
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Bettering my relationship with my child
Having my children get along better
Increasing my child's self confidence
Helping my child make better choices
Other
Are you able to commit to all meeting for this group?
*
Yes
No
Submit
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