Chronic Illness Support Group Interest Form
Hi! Please fill out this form regarding interest in the chronic illness support group. We will then be in touch via email regarding setting up a time to meet briefly to ensure the group is a good fit (unless you are already a client of Kate/Zoe's) and answer any questions you have!
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Name
Email *
Age
Location
What interests you about this group?
Are you available to meet during the group times, which is weekly on Wednesdays starting Feb 26th from 11:30-12:45 CET? The group will run through April 16, 2025.
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Anything else we should know?
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