East Bay CAMFT Peer Consultation Group Interest Form

Thank you for your interest in joining an East Bay CAMFT Peer Consultation Group. These groups are intended to provide a supportive, collaborative, and ethically grounded space for therapists to engage in professional growth, peer support, and case consultation.


Courtney "Coura" Cooke (they/them), LMFT 

EB CAMFT Peer Consultation Director

coura@ebcamft.org



Name *
Email *

Credentials/License Type (AMFT, LMFT, APCC, LCSW, Psychologist, Trainee, etc.):

 *

License or Registration Number (if applicable):

 *

Employer/Practice Name:

 *

City/Region You Practice In:

 *

How long have you been practicing/in the mental health field?

 *
1 point

What populations do you primarily work with?

1 point

What treatment modalities or approaches do you commonly use?

1 point

Are you currently receiving supervision or participating in other consultation groups? 

1 point

Which consultation group are you interested in joining?

1 point

What are you hoping to gain from participating in this consultation group?

 *
1 point

What topics or areas would you most like support or consultation around?

 *
Required

Would you prefer to meet on:

 *
Required

How often would you ideally like the group to meet?

 *
Required

Are you willing to actively participate in discussions and provide peer feedback?

 *

Are you comfortable presenting cases or clinical questions to the group?

 *

Do you agree to maintain confidentiality and avoid sharing identifying client information in accordance with HIPAA and ethical guidelines?

 *

Do you understand that this is a peer consultation group and not formal supervision?

 *

Is there anything else you would like us to know?

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