Please complete and submit the form below to apply to our next Attorney Therapy Group.  The group will meet for eight sessions, and the total cost is $1,200.00.

Apply for Attorney Therapy Group

Name(Required)
Address(Required)
Have you previously seen a mental health professional?(Required)
Do you drink alcohol?(Required)
Do you use recreational drugs?(Required)
Do you have suicidal thoughts?(Required)
Have you ever attempted suicide?(Required)
Have you ever been hospitalized for a psychiatric issue?(Required)
Do you have thoughts or urges to harm others?(Required)
Please check any of the following that apply.(Required)
Please check any of the following you have experienced in the past six months.(Required)
This field is for validation purposes and should be left unchanged.