Heart & Mind Group Registration
Please fill out the form for the person participating. If registering more than one participant fill out the form for each person. Once your information is received by the office you will receive an invitation to our client portal (if new to Heart & Mind) where you can set up password protected access to the portal, complete required paperwork and communicate with the group facilitator. If you are currently a client at Heart & Mind you will receive any additional paperwork needed for the group. We look forward to connecting with you!
Participant's First Name
Participant's Last Name
Participant's Date of Birth
Parent/Guardian's Name if applicable
Contact Phone #
City, State, Zip
Group you are registering for
Adult Connections - General Adult Support Group
Teen Connections - General Teen Support Group
Adult Adoptee Connections - Monthly Adult Adoptee Support
Teen Adoptee Connections - 8 week group for Teen adoptees
Kids Connections - Social and Emotional Growth for Elementary Age Children
True Colors - Tween Girls Group
Quarter Life Questions - Young Adult Book Study and Support Group
Heart & Mind Parenting - Thursdays (Virtually)
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