Women's Group Registration
Greetings,

ARROW Project is a grass-roots, mental-health focused non-profit serving the Shenandoah Valley Predominantly. ARROW Project is working with community partners to increase access to mental health services both to individuals historically underserved due to access and affordability as well as provide unique opportunities for community members to engage in mental health curriculum. We hope this will reduce the harmful effects of stigma and provide an environment where individuals can speak out about mental health challenges they may be experiencing. Lastly, statistics show that access to positive preventive supports reduces occurrences of mental health issues across the life span.

By submitting your contact information and signing the informed consent below, you are enrolling in ARROW Project’s Women’s Group. This weekly group is open to adult women of all ages (18+), and focuses on day-to-day emotional processing, trauma healing, and building connection among peers. Supports and coping skills will be shared to help mitigate the stress of engaging in the world today.

Time: Weekly on Tuesdays, 6:00-7:00 pm (with occasional breaks)
Location: *In-person* at 11 Middlebrook Avenue, Staunton VA 24401, as well as *virtually* via Zoom, the link for which is emailed out to registrants before the start time of group.

If you would like to participate, we ask that you review and sign the informed consent form below.

If you have any questions, please feel free to email us directly at the contact information listed below.

Jo Dicus
MA in Counseling Student Practitioner
ARROW Project
jod@arrow-project.org

Sarah Bienstock
Graduate Student Clinician
ARROW Project
sarahb@arrow-project.org

Morghan Luck
Graduate Student Clinician
ARROW Project
morganl@arrow-project.org
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Referred by (if applicable)
Are you 18 or older? *
Your Full Name *
Your Phone Number  *
Your Email *
Emergency Contact (or Guardian, if applicable) *
Emergency Contact (or Guardian) Phone Number *
Please read carefully before signing below.

This outlines the details of the women’s group therapy program that you are registering to join at ARROW Project. We encourage you to discuss any questions you may have with the group leaders before signing this consent form. Group therapy provides a supportive environment where you can discuss with other people facing similar experiences in a safe space. This weekly group is open to adult women of all ages, and focuses on day-to-day emotional processing, trauma healing, and building connection among peers. Supports and coping skills will be shared to help mitigate the stress of engaging in the world today.

What to Expect in Group Therapy:

Confidentiality:
All information shared within the group with ARROW staff will be kept confidential, with the exception of situations where there is a risk of harm to self or others and as required by law.

Group norms:
Ground rules will be established to ensure respectful interactions within the group.

Session structure:
Sessions may focus on specific topics, including discussions, activities, and sharing experiences.

Potential Benefits:
Improved coping skills, Increased self-awareness, Reduced anxiety and stress, and Positive peer support.

Potential Risks and Discomforts:
Sharing personal experiences may feel uncomfortable at times. Group dynamics can be challenging, including potential conflict with other group members. Discussing sensitive topics could lead to discomfort and feelings of distress.

Your Right to Withdraw:
You can withdraw from group therapy at any time by notifying group leaders.

Group Member Responsibilities:
Participate in group sessions. Communicate any concerns you may have about the group therapy process. **Inform group leaders weekly of intentions to attend or if you expect to be absent, as this helps create the most supportive group experience for all.**

By signing below, you acknowledge that you have read and understood this informed consent document and agree to your participation in the Women’s Group Therapy program at ARROW Project. 
 *
Electronic Signature of Registrant *
Electronic Signature of Guardian (if applicable)
ARROW Project - Middlebrook Office
11 Middlebrook Avenue, Staunton, Virginia 24401
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