ImmerseNYC Gathering: Fertility, Miscarriage, Pregnancy Loss, and Pregnancy After Loss
ImmerseNYC mikveh guides are trained to provide ritual support and to be an empathic presence--to hold a safe and open container for the stories of women and men who are struggling through these difficult moments. Please reach out to leah@immersenyc.org to schedule an immersion.

The ImmerseNYC Monthly Gathering on Fertility, Pregnancy Loss, Miscarriage and Pregnancy After Loss (facilitated by Rena Allen) will begin on December 15, 2015.

Please fill out this short form to let us know you'll join us. All information is **totally confidential** and will only be seen by the salon facilitators.
Sign in to Google to save your progress. Learn more
What is your name? *
What is your email?
Which Gathering would you like to attend? *
You are welcome to fill in the form more than once, as you know you're able to attend. You can also drop in if you can't check off the box, but RSVPs are appreciated when possible.
Required
Is there anything you would like the facilitator to know in advance?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms