DBT-C Parents Only Group Registration
This 12-week, virtual DBT skills group provides parents with practical tools for emotional regulation, utilizing the DBT-C model. With rolling enrollment, participants can join at any time. The program focuses on understanding and supporting children's emotional regulation, incorporating behavior management strategies and their application within the home.
Group Options:
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DBT-C Parent (VIRTUAL) - Tuesdays 12-1pm
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Name
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First Name
Last Name
Email
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example@example.com
Does the participant have a therapist with Peachtree DBT?
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Please Select
Yes
No
Who is your current primary Peachtree DBT therapist?
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Please Select
Jazlyn Bain
Courtney Bradshaw Baldwin
Lauren Bishop
Marisa Castro
Sarah Donnini
Alex Elliott
Simon Fragakis
Anna Hutchings
Jane Le Morrissey
Dr. Maria Silva
Luke Smith
Dr. Kim Vay
Nissa White
Shelby Salisbury
Taylor Verges
Alex Elliott
Courtney Kelly
Shane Phillips
Parent skills class participants are not required to be working with a therapist while participating in this group.
If you are currently working with a therapist, please note their name below.
Parent skills class participants are not required to be actively working with a therapist.
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Participant Information
Participant's Name
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First Name
Last Name
Participant's Date of Birth
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Month
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Day
Year
Date
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Age
Current Date
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Month
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Day
Year
Date
Best Contact Email
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example@example.com
Best Contact Number
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Please enter a valid phone number.
How did you hear about us?
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Terms and Conditions
I agree and understand that full registration and payment (including applicable outside therapist case management fee) is required to attend group.
I agree and understand that if I miss any or drop out of group for any reason, I will not be reimbursed.
I agree and understand that payment and registration confirmation emails will be sent to the primary email address submitted. Such emails may contain the health information that I submitted.
I have read and agree to the terms and conditions outlined above. I confirm that all information provided is accurate and complete to the best of my knowledge.
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Group Selected:
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