PFLAG Connects Sign-up Sheet - Formulario
Please fill out these questions to the best of your ability. This information is gathered for intake purposes only and will not be shared with anyone. Once you submit this form, we will send you an email the morning of the meeting with instructions on how to join the meeting.

Por favor responda estas preguntas lo mejor que pueda. Esta información es para uso interno y no sera compartida con nadie. Una vez que envie este formulario, le enviaremos un email la mañana del dia de la reunión con instrucciones para conectarse.
Email address *
First Name, Last Initial - Nombre, Inicial del Apellido *
Personal Pronouns - Pronombres Personales
How did you find out about this virtual support group? - Cómo se entero de este grupo de ayuda virtual?
Clear selection
Is there anything specific you would like to talk about or have the facilitator bring up during the meeting? - Algún tema en especial que le gustaría hablar o quien dirige la reunion lo haga
Are you under the age of 18? - Es mayor de 18?
Clear selection
Submit
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