Beyond the Blues: Overcoming Teen Depression
Please complete this form if you are a teenager who is interested in joining a counseling group on teen depression. Cherie will contact you by email to provide you with more information.
Email address *
Teen's First Name *
Your answer
Teen's Last Name *
Your answer
Teens Age *
Your answer
Teen's Email *
Your answer
Teen's Phone Number *
Your answer
Parent's First Name *
Your answer
Parent's Last Name *
Your answer
Parent's Email *
Your answer
Parent's Phone *
Your answer
Is there a current mental health diagnosis for the teen? Please list: *
Your answer
What depressive symptoms does the teen experience? *
Your answer
Has the teen experienced a Baker Act due to suicidal thoughts? *
Is the teen currently in counseling? If so, with you? *
Your answer
Where does the teen go to school? *
Your answer
Teens are required to purchase their own workbook for $15. *
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