Group Enquiry Form

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Group Enquiry Form

Please fill out this form and we will be in contact. The group is held every second Tuesday evening in Listowel.

Thank You,

Eileen

Full Name *

Phone Number *

Email *

How often would you like to attend the group?

(We will go with the majority preference)

Every Week.

Every Second Week

What would you like support for? Select relevant *

Relapse prevention

Managing Triggers

Anxiety

Depression

Breavement

Relationship Issues

Managing Stress

Life and Coping Skills

Mental Health

Required

How long are you in recovery? *

Have you taken part in groups before i.e. Fellowship, Smart Recovery or Aftercare/ Continuing Care groups? *

Any comments you would like to add?

Submit

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