DBT Skills Group
One adult skills group meets Wednesdays 5:30-7:00 (telehealth/video) and the other meets Thursday 5:30-7:00 (at our clinic) and we are planning to start a telehealth group Tuesdays 1:30-3:00.

Before your intake interview,  you need to complete the questionnaires and your therapist needs to complete a form and speak to your DBT intake therapist. All the details are here:

The fee is $130 for each SCHEDULED week of adult therapy groups, when the client keeps their credit card on file. Otherwise, the fee is $160 for each scheduled week of group when the client is enrolled. We do not bill insurance companies, but we provide the paperwork clients need to get their insurance to reimburse them. 
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Email *
First Name *
Last Name *
Date of Birth *
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Phone Number *
Home Address - Street Name and Number *
Primary home address
Home Address - City (Local) *
Home Address - Zip Code *
Which groups can you join? *
Required
Which group do you PREFER?
Name of your primary therapist *
Phone number of your therapist *
Are you currently employed or attending school?
Clear selection
Have you ever deliberately hurt yourself physically (e.g., cut or burned), but were not trying or expecting to die?
If so, when was the most recent time?
Clear selection
Have you thought about or attempted to kill yourself in your lifetime? *
When was the most recent time you attempted to kill yourself?
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How many times in your life, because of suicidal behavior or ideation, or self-injury, have you gone to a hospital emergency room?
How many times in your life, because of suicidal behavior or ideation, or self-injury, have you been admitted to a psychiatric hospital?
When was the most recent time?
MM
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When was the NEXT most recent time before that?
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Is a gun kept in your home? *
Name of your current psychiatrist
Phone number of your current psychiatrist
Have you ever been diagnosed with bipolar disorder?
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List other psychiatric disorders that you have been diagnosed with:
Do you have panic attacks?
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Do you have a problem with severe shame or self-hatred?
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Which of the following traumatic events have you experienced?
Have you ever been charged with any of the following?
Substance Use
Have you ever driven while drunk or intoxicated on alcohol or drugs?
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