Integrative Counseling Services' Summer Group Sign Up
All groups are scheduled to take place at our Oswego office, 5 West Cayuga Street Oswego, NY 13126. Signing up does not guarantee a spot in the group. A member of our team will reach out within 5 business days to discuss next steps.
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Parent/Guardian Name
*
First Name
Last Name
Email
*
example@example.com
May we email you at this address?
*
Yes
No
Phone Number
*
Please enter a mobile phone number.
Format: (000) 000-0000.
May we text you at this number?
*
Yes
No
May we leave voicemails at this number?
*
Yes
No
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Creating Coping Skills Pods (Ages 5-8)
Session 1: Managing Sad Feelings: Tuesday June 30th 11:00 AM - 11:45 AM
Session 2: Managing Anxious Feelings: Friday July 17th 9:30 AM - 10:15 AM
Session 3: Managing Anger: Monday August 10th 1:30 PM - 2:15 PM
Creating Coping Skills (Ages 9-12)
Session 1: Managing Depressive Feelings: Tuesday June 30th 12:00 PM - 1:00 PM
Session 2: Managing Anxious Feelings: Friday July 17th 10:30 AM - 11:30 AM
Session 3: Managing Anger: Friday August 22nd 2:30 PM - 3:30 PM
What insurance do you have?
*
E.g. Fidelis, Medicaid, Excellus Blue Cross Blue Shield, etc.
Insurance Card
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Please upload a picture of the front and back of your insurance card.
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Have you been in counseling before?
*
Yes
No
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