The Invisible Trimester Group Sign Up
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Welcome! This is a drop-in pregnancy support group for people in their first trimester. You only need to fill out this form once — after that, you’re on the roster and welcome to join any session.

Please complete this form before attending your first group. Your responses will remain confidential.

Day/Time: Wednesdays, 12-1:00
Cost: $25/group
Location: Reproductive Psychiatry & Counseling, 4022 Menchaca Rd., Austin, TX 78704
First Name *
Last Name *
Are there any other identities that you hold which you'd like us to know about? (Sexuality, ethnicity or race, physical ability, etc.)
Briefly, what are you hoping to get out of this group? 
RPC's First Trimester Support Group will be facilitated by Emily Obront, a fully licensed RPC therapist.

-Emily Obront is a Licensed Master Social Worker (LMSW) licensed by the State of Texas, number 66064.

Emily is supervised by Elaine Cavazos, Licensed Clinical Social Worker, licensed by the State of Texas, number 20632. Emily is required to engage in regular supervision with Elaine Cavazos, LCSW-S for all of her client cases as she works towards her independent licensure. Elaine Cavazos is required to abide by the same regulations regarding confidentiality as Emily. Emily and Elaine's supervisory relationship has been set up in accordance with the laws in Texas that govern social work. Emily may seek professional consultation about your care with other colleagues in an effort to provide the most complete treatment. Information about you may be shared in this context without using your name.
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Required
- Group members must enter the meeting room within 15 minutes of the group’s start time; after this time, the room will be closed. 
 - If a group member does not show for a scheduled group session and has paid in advance, they will not be reimbursed for that session.

 *
Required
We do not complete disability or legal paperwork.

For medical emergencies, please call 911

RPC therapists are not available to provide crisis services.

Due to the importance of your confidentiality and minimizing dual relationships, we do not accept friend or contact requests from current or former clients/group members on any social networking sites (Facebook, LinkedIn, etc.). We believe that adding clients/group members as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our relationship.
 *
Required
If communication in a language other than spoken English is required, please let us know at the time the session is scheduled, and at least one week prior to the scheduled session.

The client may be responsible for the certified translator fee.

If a translator is not available in the language that is requested, we will be unable to do the program.
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Required
Either an individual group member or the group facilitator has the right to terminate the member’s participation in the support group at any time. Reasons for termination by RPC group facilitators include, but are not limited to:

-Weapons of any kind were brought to the clinic.
-Demeaning language or behavior was repeatedly used.
-The group member’s behavior during sessions is threatening or poses potential harm to another group member or the RPC group facilitator.  
Please sign below once you have read the policies of the First Trimester Support Group and agree to the above terms.  If you have questions or concerns regarding the above policies, please do not sign this form and contact the clinic instead.

By signing below, you also agree we may contact you by telephone at any telephone number associated with your account, including wireless telephone numbers, which could result in charges to you. We may also contact you by sending text messages or emails, using any email address you provide to us. These may be used as group reminders, you can unsubscribe at any time. Methods of contact may include using pre-recorded/artificial voice messages, and/or use of an automatic dialing device, as applicable.
Please type your full name to indicate your legal signature: *
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