DBT Skills Group - Wait list/Interest Form
Thank you for your interest in our DBT Skills Group at Radical Healing. To help us maintain a list of interested folx, please complete the following form. Our skills group is on hold during the COVID-19 pandemic and plan to begin groups again in person when it's safe to do so.

PLEASE NOTE: Since this form is transmitted electronically, confidentiality cannot be guaranteed, If there is any question you prefer not to answer electronically, please let us know by completing the last form response and we can schedule a time to meet with you over the phone or in person or leave a voicemail at 919-960-1396.
Name *
Date of Form Completion *
Pronouns *
Phone Number *
Do we have your consent to... *
How did you hear about us?
Do you have preference for meeting times?
In what meeting format are you interested in participating?
Are you currently working with a DBT therapist or any therapist?
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