DBT Skills Group Request Form
If you are interested in joining a DBT skills group through Meridian DBT and Psychotherapy Services, please complete the following form.
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This form will put your name on an interest list for DBT skills groups at Meridian. This is NOT a waitlist. When an opening arises in any group, an email will go out to all members on the interest list and is first come, first serve.
Full name *
Preferred name and pronouns *
Email *
Phone number
What age group are you looking for?
Clear selection
I am interested in: 
My insurance/method of payment is: 
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I am currently in or seeking individual therapy. I understand that DBT Skills Group is not a replacement for individual therapy and I must have an individual therapist to participate in skills group. 
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I understand that DBT skills group is a content-focused teaching group and is not designed for discussing or processing individual experiences or emotions.
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I understand that I am expected to attend all groups and that the full rate of any missed groups will be charged out of pocket (Medicaid exempt)
 *
I understand that completing this form does not guarantee me a space in a DBT skills group. I understand that I will not receive an individual email from the group leaders following my completion of this form. 
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I consent to having my email put on an interest list and receiving emails when spaces in a group arise. Emails will be protected and not visible to the rest of the email list.
 *
Is there anything you would like group leaders to know?
Submit
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