Virtual Teen Talk Group: REGISTRATION FORM
Many teens do not have the skills needed to cope with this unprecedented time. Group therapy is a great source of support and growth for teens. The Virtual Teen Talk Support Group is designed to educate and support teens as they navigate this time of uncertainty to make daily living more manageable.

The group meets virtually on Tuesdays 3:30-4:30pm. 9th-12th grade boys and girls are welcome to join. Teens can join the group after each participant or parent completes the registration form and speaks with a group facilitator. Once joining Teen Talk, each teen must commit to attend for a minimum of six weeks as regular attendance is necessary for the group to be successful. Participants can pay per session ($70 each) or for a 6 week group session package ($397 for package of 6).
First Name *
Last Name *
Your Child's Full Name *
Your Child's Date of Birth *
Phone Number *
Email Address *
Mailing Address (Please include street, city, state, zip code) *
What grade is your child in? *
What school does your child currently attend? *
What group option would you like to sign up for? *
Thank you for your registration! An invoice is winging its way to you! You will receive it within 24 hours of submitting your registration. If you have any questions, please don't hesitate to reach out to
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