Name *

First Name

Last Name

Phone *

This is necessary for SimplePractice registration and will be used to send appointment reminders. I will never use your phone number or email for spam.

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Registration *

I am ready to register and would like to be added.

I have questions but I am interested (please add question below)

The group is full but I'd like to be added to your mailing list for future groups!

Select Dates to Register For

Please select all groups you would like to register for. Paperwork and calendar confirmations will be sent through SimplePractice.

August 1 (12pm - 2pm CST)

September 5th (12pm - 2pm CST)

October 10th (12pm - 2pm CST)

November 7th (12pm - 2pm CST)

December 5th (12pm - 2pm CST)

I understand this group runs from 12pm-2pm CST - I have made sure this works with my time zone. I also understand this group costs $100/group and Amanda has a 48 hour cancellation policy. Should I fail to cancel within 48 hours I understand my card on file will be charged. *

I understand.