Interest Form for Online Skills & Support Group:    Finding Peace in Pain and Chronic Symptoms with Laura Cunningham M.Ed., LPC
I am so excited for your interest in this group!  This is an ONLINE education & skills group, not a therapy group, it meets online, and is for people 18 years and older who have had pain or chronic symptoms for 10 weeks or longer. 
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Email *
Important details about the group: 
Your pain and symptoms are real, AND there are ways to reduce pain and some symptoms with skills we will cover in our group. This group will provide support to help you find some relief and peace on your journey. This is not group therapy or counseling, this is for education and gaining practical skills to help you.

This online group will last for 5 weeks on Tuesdays from 12noon through 1pm from October 7 through November 4. To ensure that we have people joining and the right fit for our group, please fill out the following form and Laura will get back to you to schedule a call to see if this is the right group for you! Laura will tell any interested person if they are or are not a good fit for the group and will be up front about that on your interest call. 

This is a closed group for those who have signed up by/before 10/5 - and only for those who have filled out this form, spoken with Laura and are given by Laura the green light to join can be in the group. 

Pay in full one-time payment for $250. 
Or two installments of $135 each (1 before Oct. 7 and the 2nd before Oct 21)

If you miss a session I will share via email a recording of the skills portion of the session you missed. There will be no refunds.

If you have any further questions about this group, please feel free to contact me at: 
806-786-0918 or laura@lauracunningham.net

Now please fill out the following form if interested in this group!

I am so glad for your interest in this online group! 

If you haven’t filled this form out already and you would be interested in joining - please fill out the following form for the 5 week group October 7-November 4 after the first FREE webinar-style online meeting (Intro to Finding Peace in Pain and Chronic Symptoms on September 30):
Full Name *
Address *
Phone number *
Have you had your pain/symptom for longer than 10 weeks?  *
Please describe in 2-3 sentences what ways/when your symptoms/pain show up and to what severity (1-10 - 10 being unbearable) and frequency.  *
Which of the following days/times would work for you to schedule a clarity call with Laura to see if this group is a right fit for you?  *
Required
If I haven’t done so already - I will call you once I receive this form to hear more about your interest in the group and see if this group is a good fit for you!  If you do not set up a call with me before October 5 I will assume you do not want to participate. 

Payment Options will be discussed on our screening call.
A copy of your responses will be emailed to the address you provided.
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