• Support Group Pre-Screening & Registration Questionnaire

    She Rested, Then Rose – A Mental Wellness Group for Black Women Entrepreneurs

  • đź–¤Welcome, Sis.

    So glad you’re here.She Rested, Then Rose is a healing-centered therapy support group created by and for Black women entrepreneurs who are holding so much, giving so much, and ready to reclaim space to breathe, feel, and heal.This space is about more than business—it’s about you. The whole you. Beyond the hustle.We honor the courage it takes to show up for yourself in this way.Please take a few moments to complete this form. Your answers will help us make sure this group is the right fit for your healing goals. All responses are kept confidential and reviewed only by the facilitator(s).

  • NOTE: This is a new group that is actively being filled. Once the minimum number is reached, all accepted participants who responded will be emailed with further information and your client portal will be set up. 

     

    This group is not a good fit if you are in a state of crisis, have been diagnosed with moderate to severe depression, have a mood disorder or personality disorder diagnosis, or if you have an ongoing, untreated mental challenge or illness that is not being treated by an individual licensed professional.

  • Preferred Name (if different)

  • Pronouns*
  • Format: (000) 000-0000.
  • Age*
  • I prefer to be contacted? (Check all that apply)*
  • Are you a licensed therapist or wellness provider?*
  • Do you identify as a Black?*
  • Do you identify as a woman (inclusive of trans, cis, queer, and nonbinary femmes)?*

  • I understand that this group is for black women. (Please stop here if you are not a black women and reach out to see if we have another group that can accommodate you.)*

  • Have you ever participated in a therapy or support group before?*
  • Do you feel comfortable sharing and listening to others in a group setting? This is important as you will be apart of an online support group.**
  • Are you currently seeing a therapist or counselor?**
  • Have you been diagnosed with severe depression, mood disorder, PTSD, or a personality disorder that requires ongoing, individual treatment?*
  • Are you currently a business owner or entrepreneur?*
  • How long have you been in business or developing your venture?*
  • What are you hoping to gain from this group? (Check all that apply)*
  • On a scale of 1–5, how often do you prioritize your mental/emotional wellbeing in your business journey?

  • This group is built for Black women entrepreneurs who are:


    ✔️ Open to self-reflection and healing
    ✔️ Respectful of community care and diverse lived experiences
    ✔️ Committed to showing up for themselves and others
    ✔️Not currently in an acute mental health crisis

     

  • Does this describe you at this time?*
  • Are you able to commit to 6 weekly 90-minute group sessions?*
  • Should be Empty: