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Women’s Support & Empowerment Group Interest Questionnaire

Thank you for your interest in our upcoming Women’s Support and Empowerment Group! Your responses will help us tailor the group to meet your needs and preferences. Please take a few minutes to complete the following questionnaire:

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Are you interested in joining a women’s support and empowerment group?
Question Type
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1.
Yes
2.
No
3.
Maybe
4.
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Answer key
(0 points)
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Desired Topics of Interest**

What topics are you most interested in exploring in the group? (Select all that apply)

Question Type
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Building Self-Esteem and Confidence
Navigating Relationships (e.g., communication, boundaries)
Career and Professional Development
Motherhood and Parenting Support
Coping with Life Transitions (e.g., divorce, aging, empty nest)
Trauma Recovery and Healing
Mental Health and Wellness (e.g., anxiety, stress management)
Mental Health and Wellness (e.g., anxiety/ stress management)
Mindfulness and Self-Care Practices
Spirituality and Inner Growth
Grief and Loss Support
Sexuality and Intimacy
Social Issues and Advocacy (e.g., feminism, women’s rights)
Other:
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Preferred Days of the Week***Which days of the week work best for you to attend the group? (Select all that apply)

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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
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or
add "Other"
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Preferred Time of Day*** What time of day would you prefer the group to meet? (Select all that apply)**

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Morning (8 AM - 12 PM)
Afternoon (12 PM - 4 PM)
Evening (4 PM - 8 PM)
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or
add "Other"
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Preferred Frequency of Meetings***

How often would you like the group to meet?

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Weekly
Biweekly
1x monthly
Other:
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Preferred Group Size***

What group size would you feel most comfortable with?**

Question Type
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Small (4-6 participants)
Medium (7-10 participants)
Large (11-15 participants)
No preference
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or
add "Other"
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****Why paying out of pocket for therapy might be the best choice for you

When it comes to mental health counseling, choosing to pay out of pocket rather than going through insurance can offer several key benefits. Please click the link below for an explanation of benefits to private pay therapy services. 

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Pricing and Affordability****

Which payment option would you prefer? (Select all that apply)**

Question Type
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Pay per attendance
Monthly fee
Insurance only
Sliding scale (based on income)
Other:
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(0 points)
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**Additional Comments or Suggestions**

   - **Please share any additional thoughts, suggestions, or preferences you have for the group:**  

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Are you interested in joining a women’s support and empowerment group?
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No responses yet for this question.

Desired Topics of Interest**

What topics are you most interested in exploring in the group? (Select all that apply)

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No responses yet for this question.

Preferred Days of the Week***Which days of the week work best for you to attend the group? (Select all that apply)

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Preferred Time of Day*** What time of day would you prefer the group to meet? (Select all that apply)**

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No responses yet for this question.

Preferred Frequency of Meetings***

How often would you like the group to meet?

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No responses yet for this question.

Preferred Group Size***

What group size would you feel most comfortable with?**

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No responses yet for this question.
****Why paying out of pocket for therapy might be the best choice for you

Pricing and Affordability****

Which payment option would you prefer? (Select all that apply)**

Copy chart
No responses yet for this question.

**Additional Comments or Suggestions**

   - **Please share any additional thoughts, suggestions, or preferences you have for the group:**  

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