Registration

Use this form to request to reserve your seat!

First Name

Last Name

Phone

Group

Are you, or have you been, a patient of Restoration Psychological Services?

Current patient (i.e., individual, couples, or family therapy)

Previous patient

Have attended other groups

By checking this box, I am indicating that I understand that I will be invoiced a $20 registration fee in order to reserve my spot in the requested group if I move forward with registering fo the group.

Following this request to register, contact will be made by admin or facilitator to gain further information to ensure all participants are a good fit for each group/workshop.

I want to subscribe to receive information about group and other services with Restoration Psychologial Services.

Thank you for your interest!

Registration

Use this form to request to reserve your seat!

RESTORATION