Write It Out! A creative counseling group .
Writing, especially creatively, can have therapeutic elements such as self expression, self reflection, and mindfulness. In this group, CWHC Counselors Ethan and Shelly will facilitate group process while prompting group members to write creative nonfiction, reflect on, and share their work. They will create space for the processing of the elements, themes, and emotions that arise from the group tasks.
Please note: this is not a trauma process group.
First (or Preferred) Name *
Last Name *
Pronouns *
Gender Identity *
Date of Birth *
Race/Ethnicity *
If you identify as a race/ethnicity not listed, please specify:
Email Address *
Is it ok for facilitators to send a detailed message to this email address? *
Phone Number *
Is it ok for facilitators to leave a detailed voicemail at this phone number? *
What are some topics you would like to be covered in this group?
This group will meet weekly on Fridays from 2-3:15pm beginning on March 29th and ending on May 17th. What, if any, are some barriers that could possibly prevent you from regularly attending this group (such as school, jobs, etc.)?
Sliding fee for this group starts at $25, but can go lower based on need. What is an amount you feel comfortable paying per group session?
Once you register, a facilitator will contact you to discuss the fee scale in more detail.
Anything else you would like the facilitators to know about you?
Never submit passwords through Google Forms.
This form was created inside of Chicago Women's Health Center. - Terms of Service