Birth Trauma Therapy Group
This form is to pre-screen potential group members. Due to the nature of the topic, members must be pre-screened to ensure group integrity. After pre-screen is complete, a brief phone screening will be scheduled to ensure group fit. 

Group will be facilitated by Alicia Schuster-Couch, MA, LPC, PMH-C. Please contact Alicia at 256-755-4599 for questions.
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Email *
Name *
The group will be held every Tuesday, starting January 7th. The group will meet from noon until 1:30pm for nine sessions. It will conclude on Tuesday, March 4th. Can you commit to attending group every week? *
Each group session will cost $45 each (for 9 sessions). A card will be placed on file and charged $45 on the date of the session. Do you acknowledge the price of the group? *
Have you experienced a traumatic birth? *
How long has it been since your traumatic birth? *
Did you experience catastrophic perinatal loss during your traumatic birth? *
Have you participated in therapy since your traumatic birth? *
Do you reside in the State of Alabama?
*
What do you hope to gain or experience from participating in group therapy? *
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