Parent/Caregiver Support Groups at JS Therapies
You've asked...we've listened! We are excited to offer Support Groups for parents & caregivers to connect and support each other! NOW AVAILABLE...therapeutic childcare!!

Our vision for these support groups, rather than a therapist-led group, is a space for YOU to connect with each other in ways that are most meaningful for you -- this could be spending time together talking through challenges you're having at home, sharing tips of what you've found helpful, connecting each other with other local resources, and hopefully creating connections that extend outside of the group...we'd love to see your children becoming friends with each other as well! 

Our therapy team will lead small group activities for your children during this time. It is important that you sign up in advance so that we can prepare for these sessions. 

MONTHLY MEETINGS: Last Thursday of each month, 6-7pm at Suite 111 of JS Therapies.

Please feel free to comment at the bottom of this form with any special requests or suggestions as we co-create this supportive space together!! 

Thank you, as always, for trusting us with the care of your precious children, 

the JS Therapies team

Questions? Text Amanda: (712) 541-5905.
Sign in to Google to save your progress. Learn more
Email *
Location *
Caregiver First Name *
Caregiver Last Name *
Will your child be attending? *
Child First Name *
Child Last Name *
Child Date of Birth *
MM
/
DD
/
YYYY
Does your child have a diagnosis? *
Required
If you plan to bring another child, please list name and age below as well. 
Phone Number *
Other Parent/Caregiver First & Last Name
Pediatrician  *
What are the primary concerns you're seeking support for?  *
Required
How did you hear about us? *
Do you currently receive services at JS Therapies? *
Anything else you'd like us to know about your family, your concerns, or suggestions for this program?
Support Groups & Child Groups - last Thursday of every month!
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of JS Therapies.

Does this form look suspicious? Report

Google Forms