Support Group Intake Form

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Page 1

Dear Fellow LDS Community Members,

This support group is designed to:

  • Share your personal experiences with LDS
  • Unpack your difficulties with this condition; and 
  • Find comfort within OUR community

To best serve your needs, please take approximately 5-10 minutes to respond to the following questions.

Thank you in advance and we look forward to meeting you!

Primary Information

Page 2

Confidentiality and Data

    All participants are required to:

Note: The additional forms are not needed to reserve your spot in any upcoming sessions but are required before the start of your first session.
Thank you for taking the time to fill out this survey. It's important to remember that you are not alone. Within this support group, you will find others who share the daily struggles and triumphs of living with LDS. 

Please continue to the Signature Page to complete your registration.