PEERS® SOCIAL SKILLS GROUP                            
We have groups for teens and young adults with Autism, social anxiety, ADHD, or other social difficulties.
If you are interested in enrolling in this program, please complete the short questionnaire below to help us determine if PEERS® may be a good fit for you and your social coach. You may also contact us anytime with questions at (860) 270-0600.
Sign in to Google to save your progress. Learn more
Email *
First and Last Name of Applicant
Age *
Diagnoses (if applicable)
First and Last Name of Parent/Caregiver (if applicable - note: social coach is required) *
Phone number *
What difficulties does the applicant have with making and keeping friends? Check all that apply. *
How did you hear about us?
Any questions or comments?
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy