Facing Heartbreak - Group Registration
Facing Heartbreak is a group for spouses and partners who have been impacted by sex - porn addiction or infidelity Nothing quite touches our lives like the power of connection with others who understand and care because they have been there themselves. And when this kind of connection happens within a setting that provides a specific process for healing that is facilitated by who has experience in working with spouses and who has also been there, the power of connection is magnified ten-fold.

Meets bi weekly

Cost is $50 per group - session
If you would like to prepay for all 12 weeks the cost is $500 an $100 savings

Location:

Bevill and Associates
2524 Valleydale Rd
Suite 100
Birmingham, AL 35244

Directions:
To participate in this group you must currently be in counseling and refereed by your counselor for group therapy or if you'r currently not in counseling you will need to schedule an appointment to be evaluated for participation in the group.

Space is limited to 8 participants.

A $50 no-refundable deposit will be charged to your credit card at the time of registration. This amount will be credited to your first group - session.

You will be notified if you are admitted into the group
You will be notified if you are placed on a waiting list should we reach capacity.

To register please complete the information below and then click the "Submit" button.

First Name *
Your answer
Last Name *
Your answer
Marital Staus *
Email Address *
Your answer
Phone Number *
000-000-0000
Your answer
Street Address *
Your answer
City / State/ Zip *
Your answer
Current Counselor or Therapist *
Name and Telephone Number
Your answer
Credit Card Authorization: I, authorize the maintenance of valid credit card information to guarantee my chosen payment option. Charges will appear on your credit card statement as “Bevill and Associates LLC.”
How do you plan to pay for group *
Pre Pay or Per Session
Cardholder Name *
Your answer
Type of Card *
Card Number *
Your answer
Exp. Date *
Month / Year
Your answer
CVV Code *
Your answer
Billing Address *
Street - City - State- Zip Code
Your answer
Payment Guarantee: I understand that I am individually responsible for all incurred charges, even if I direct you to bill another person. If I direct charges to be billed to another person, I represent that I am authorized to give you such direction. If I have directed you to bill charges to another person who fails to make payment promptly when due, I will promptly pay on demand. I understand that if I commit to joining a weekly therapy group, In the event that I dispute a credit card charge without first trying to resolve my concern directly with Bevill and Associates LLC I agree to reimburse Bevill and Associates LLC. $25 per disputed transaction to compensate Bevill and Associates LLC for the costs incurred in trying to recover disputed funds. *
By typing your full name below indicates your agreement. *
Your answer
Submit
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