SABR Registration Form

SABR/Tribe - PHASE ONE REGISTRATION

PLEASE NOTE: Prior to enrollment ALL participants must complete an intake assessment with, and be referred by, a Family Strategies SABR therapist. During that assessment you will be given the SAST (Sexual Addiction Screening Test) and receive a score that you will need for registration.
Client Information

There is a $100 materials fee per participant due at the time of enrollment. All group participants are required to have a credit card on file with Family Strategies unless you have made prior arrangements with our billing department. You will be prompted at the end of this registration for your payment information.
Full Name *

First Name Last Name
Date of Birth *

Month Day Year
mm/dd/yyyy Date Picker Icon
E-mail *
Phone Number *

Area Code Phone Number

Address *

I am registering for: *

SABR Tribe (18-24 yr. old singles) Retake Education Group/Phase One (Only for those who have previously completed Phase One). There is no charge to retake Phase One unless you would like new workbooks ($100 materials fee).
I have completed an intake session with, and have been recommended for the SABR / Tribe program by: *
SAST Score (Select one): *
If you are the partner of the addict and have not taken the SAST, you may select "0".
Who is your current therapist?
If other, who is your therapist?

SABR/Tribe - PHASE ONE REGISTRATION