Loving Your Partner with ADHD (Group) Interest Form
Welcome! I'm glad you’re here. Chances are, you’ve found this group because you’re looking for support and connection. This support group will begin in 2026 and will meet online through a secure, HIPAA-compliant telehealth platform. Members can join anywhere within the state of California. Dates and time TBD.

Please take a few moments to complete this form so I can gather some basic information. If you have any questions, don’t hesitate to reach out directly.

Facilitated by Shannon Fennell AMFT, #152781
Supervised by Kristi Miller, LMFT #111558
Tel: (805) 617-0967‬
Email: Shannon@RivieraTherapy.com
Website: www.rivieratherapy.com
Instagram: @supportwithshannon
Sign in to Google to save your progress. Learn more
What is your first and last name? *
What is your phone number? *
What is your email? *
Please share a little bit about your relationship with someone with ADHD and what you hope to gain from this support group. *
This group will be on Monday evenings and will last 60-75 minutes, depending on the number of participants. Please indicate your preferred start time.  *
Required
Feel free to share any other information you think would be helpful for me to know.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms