RCC Support Group Signup Form
We are running three support groups this fall--sign up below!  This form is the first step.  You will receive a cost estimate email from us and will have the chance to approve the cost and start date before we confirm your first group meeting.  You can visit our Groups page to learn more about the groups and to contact group facilitators with your questions.    
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Which group would you like to sign up for?  (Check all that apply) *
Your First Name *
Your Last Name *
The email address you'd like to use for the group *
The best phone number to reach you *
Do you already have a client profile using your full name?  (I.e. if you have worked with an RCC therapist before then you should) *
Do you have any other therapy sessions booked at RCC on the same day as your group will meet?  This is imporant:  you can only bill insurance for one therapy service each day.  If you attend a therapy session on the same day as your group, one claim will be denied and you will owe the $60 group fee.   *
Please share any questions you may have?
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