Togetherness Therapy Singles Process Group (Fall 2023)
Thank you for expressing interest in the singles process group! In the group, we will cover how to find compatible partners, get yourself more matches on dating apps, and ways to reduce anxiety. We will also discuss dating patterns and how to be your most authentic self when dating. Please fill out this short survey to assist us in creating a group that best suits your needs. We appreciate any feedback and will try to incorporate your suggestions into our groups.
Name
*
First Name
Last Name
Email
*
example@example.com
1. Please indicate your gender
*
Female
Male
Other
2. Please select the category that includes your age
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18-24
25-34
35-44
45-54
55-older
3. Would you prefer a mixed gender group or single gender group? A mixed gender group is one comprised of all genders. Single gender is all male or all female. You may also select "no preference."
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Mixed gender
Single gender
No preference
4. How would you describe your personality?
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Shy and introverted
Brave and talkative
Easy-going and cheerful
Honest and reliable
Observant and quiet
Sympathetic and tolerant
Energetic and open minded
Other
5. Group will be fully virtual, which means we will meet online via Zoom. Will this work for you?
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Yes
No
6. Groups are projected to be on Tuesdays from 6 PM - 7:20 PM starting September 26th. This group requires a 6-week commitment. Will you be able to attend?
*
Yes
No, and I am not interested in the next waitlist.
No, please add me to the next wait list.
Other
If you are unable to attend the group time listed above, please indicate time preferences you have. Please list specific days and times that you are available. For example, Monday mornings between 9am-12pm, Wednesday evenings between 5pm-8pm, etc.
7. How would you describe your dating experience? Organic dating is meeting someone randomly, in-person. Select all that apply.
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Not much dating experience
Just getting started with dating
Have tried to date, but encountered difficulty finding compatible partners
Have tried only in-person, organic dating
Have tried only dating apps
Have tried both organic dating and dating apps
Other
8. How would you describe your relationship experience? Long-term relationship is 2+ years. Short-term relationship is defined as less than 2 years. Casual sexual relationship with no commitment would be like friends with benefits or one-night stands. Select all that apply.
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I have never been in any type of relationship.
I have only had casual sexual encounters, no committed relationships.
I have only been in short-term relationships.
I have been in both short-term and long-term relationships.
I have been in one long-term relationship.
I have been in several long-term relationships (2 or more).
I have had casual sexual encounters, short-term relationships, and long-term relationships.
9. What are you looking for when you date? Select all that apply.
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Friendship
Casual sexual encounters
Short-term relationships
Serious, long-term relationships
Unsure
Other
10. What do you want to learn from the singles process group? Ex. coping with anxiety around dating, self-esteem, dating tips, dating etiquette, online dating, etc.
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11. What would you like to gain from the group experience?
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Confidence
Social skills
Dating skills
Decreased anxiety
Sense of belonging
Healing from past dating experiences
Flirting skills
Finding patterns in my dating styles
Other
12. What makes dating a challenge for you?
*
13. How comfortable are you with discussing relationship and sex topics with others?
*
Please Select
Very uncomfortable
Somewhat uncomfortable
Neutral
Somewhat comfortable
Comfortable
Very comfortable
13. What is the MOST you are willing to pay for each group session, assuming groups are 1.5 hours long for 10 weeks?
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Less than $50 per group
$50-$70 per group
$70-$90 per group
More than $90 per group
14. The group cost is $75 per session (each session is 1.5 hours long). You will be charged at the end of each session. To secure your spot, we ask that you submit a credit card on file by September 22nd. Will this work for you?
*
Please specify if you will need financial assistance, if so, how much are you able to pay? Please describe or list and financial barriers you may have at this time.
15. Is there anything else you'd like us to know or are there any suggestions you have for us? Do you have any questions?
*
16. How excited are you about starting the singles process group?
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not very excited
1
2
3
4
very excited
5
1 is not very excited, 5 is very excited
Submit
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