SPACE Group for Treating Childhood Anxiety
Welcome and thank you for your interest in SPACE. This form is for those who would like to participate in the SPACE group class. Currently we are accepting applications for the 2025 cohorts, beginning Wednesday, June 4, 2025 at 11:00am.

The cost for the 10-week treatment group is $1225 and you can submit payment electronically through PayPal at sheenahill43@gmail.com or Venmo at Sheena-Hill-43.

Please email me at info@sheenahill.com with questions or concerns.    
Sign in to Google to save your progress. Learn more
Parent's name and email address *
Who will be participating in our group? *
What are your goals for completing the SPACE protocol? *
How would a reduction in your child's anxiety change your family? *
Next
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