Recovery Wellness Registration Form - 2nd & 4th Mondays at 6:30 pm
Please fill out this form to register for our upcoming event.

A supportive space for justice-impacted individuals walking through hard things. Whether your recovery is from trauma, mental health challenges or substance use disorder, this group offers community, understanding and tools for healing.
Email *
First Name *
Last Name *
Email Address *
# Attending (including yourself) *
Accessibility or confidentiality needs we should be aware of *
Which day(s) will you be attending? *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of dismasin.org.

Does this form look suspicious? Report

Google Forms