Tuning In To Kids - Registration Form
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Parent Full Name *
What is your best email address? *
What is your best contact phone number? *
Will a co-parent, caregiver, and or partner join the sessions? If yes, please write their name, phone number, and email address below. *
How many children do you have and what are their ages? *
What are your main parenting concerns or goals? (e.g., emotion regulation, managing outbursts, communication). *
If you have a current clinician at Mindbox Psychology or the Selective Mutism Clinic, please write their name below. *
Payment

Payment for the program is required in full at the time of registration to secure your place. Please note that we do not offer refunds, so we encourage you to consider your availability before registering.

Confidentiality 

Confidentiality is a fundamental principle of our group, ensuring that all discussions and personal experiences shared within this space remain private. It means that what is said in the group stays in the group, fostering a trusting environment where members can feel safe and supported. Maintaining confidentiality and privacy is essential for honest communication and building meaningful connections. As a member, we ask you to commit to respecting the confidentiality of others in the group. 

We will now ask you to commit to privacy and confidentiality, commitment helps maintain a safe and supportive environment where everyone can share openly without fear of judgment or exposure. 

Please type your name below, to indicate that you have read and agreed to the above payment and confidentiality information. 
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