Boris L. Henson Free Group Sessions with Barber Therapy and Associates
The Boris L. Henson Foundation is sponsoring Free Virtual Groups for teens and young adults (male or female). The facilitator of the groups will be Barber Therapy and Associates owner and lead therapist, Sherille Barber. This is a national initiative to provide services to those in need, completely FREE. For more information on the foundation, please visit their website, 
Please select the age level. *
Participant's Name (please provide the first and last name) *
Participant's Date of Birth *
Participant's Email Address (Enter parent/guardian email if participant does not have personal email address) *
Participant's Phone Number (Enter parent/guardian phone number if participant does not have personal email address) *
Address (participants must live in North Carolina or South Carolina) *
Parent/Guardian Name (first and last name) *
Parent/Guardian Email Address *
Parent/Guardian Phone Number *
Never submit passwords through Google Forms.
This form was created inside of Barbertherapy & Associates. Report Abuse