Name *

First Name

Last Name

Phone *

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Workshop(s) you are attending *

Foundational Workshop

Parent Empowerment & Application Group

Validation: Learning Teen Speak - June 24

In It Together: Problem Solving With Your Teen - July 15

Ready, Set, Go: Coping Ahead for Transitions - August 5

Have you completed our Foundational Workshop or a DBT skills group?

Foundational Workshop

DBT skills group

None

Name of second participant (if applicable)

First Name

Last Name

Second Participant Phone

(###)

###

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