Pet Loss Support Group Enrollment Form Logo
  • Pet Loss Support Group Enrollment Form

    CCC is providing an 5 week Pet Loss Grief group. This is not a drop-in support group but one that allows members to develop a trusting relationship with one another throughout the course.
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  • Emergency Information

  • Emergency Contact

  • Demographic Information

    Responding to this section is voluntary and will help us assess our service to various communities. The information you share will not be used to identify or determine your immigration status, and will not be reported to the authorities. You may choose not to answer any question(s).
  • Household Information

  • Rights and Responsibilities of Group Memebers

  • In-Person and Online Meeting Information

  • Fees and Payments

    The Center for Community Counseling is a not-for-profit that strives to provide access to therapy through a sliding scale feel to those who would not otherwise be able to access therapy. We rely on the fees of our clients to continue to offer this service.
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