• Raices in Consulta Clinical Consultation Group Registration

    Please complete this form to register for the upcoming Bilingual Counselor Consultation group. Once this form is completed, you will be invited to the virtual group.
  • Format: (000) 000-0000.
  • Professional License Type
  • Years of Clinical Practice
  • I understand that Raíces en Consulta is a peer consultation group and does not constitute clinical supervision, individual counseling, or group therapy. Participation in this group does not establish a supervisory or therapeutic relationship with the facilitator(s) or other members, and it does not satisfy formal supervision hour requirements.

    I understand that this group is confidential. Case material, discussions, and any information shared by participants are to remain within the group and will not be disclosed outside of it. I agree to uphold this confidentiality for anything shared by other members, and I understand that, as with any group format, confidentiality cannot be guaranteed with absolute certainty.

    By clicking REGISTER below I confirm that I have read and understood the statements above and agree to participate under these terms

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