Restoring Resilience Group Support Application
Mental Fitness C.R.E.W: Center for Resilience Empowerment & Wellness
Your Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Do you live in Michigan?
*
Yes
No (We are only licensed to provide services to clients who reside in MI)
Email
*
example@example.com
What are your primary reasons or concerns for seeking group support at The Mental Fitness C.R.E.W: Center for Resilience Empowerment & Wellness?
*
Which Restoring Resilience THERAPY GROUP are you applying for?
Adults with Ongoing Health Conditions
Support for Caregivers (of someone with ongoing health conditions)
The group will meet virtually for six weeks Tuesdays at 11am beginning January 27th. After your application is reviewed, you will receive an email with a registration link confirming your commitment to attend all six sessions and approval of the total program cost of $270 ($45/session). Payment in full is required at registration and is non-refundable for missed sessions or withdrawal. Please note that we do not bill insurance for group costs. Do you agree to these terms?
*
Yes
No
Submit
Should be Empty: