top of page
Home
Info
About
Services
Contact Us
More
Use tab to navigate through the menu items.
M
ind
Reneural
Minds in Motion Group Registration
First name
*
Last name
*
Pronouns
He/Him/His
She/Her/Hers
They/Them/Theirs
Birthday
Month
Day
Year
Email
*
Phone
Why do you believe this group is right for you?
What mental health challenges are you currently working through?
Anxiety or excessive worry
Depression or low mood
Trauma or PTSD
Grief or loss
Anger or irritability
Relationship challenges
Self-esteem or confidence issues
Social anxiety or isolation
Emotional regulation difficulties
Self-harm or suicidal thoughts
Substance use or addiction
Disordered eating or body image concerns
Attention or focus difficulties (e.g., ADHD)
Obsessive thoughts or compulsive behaviors (OCD)
Identity exploration (e.g., gender, sexuality, culture)
Life transitions or adjustment challenges
Coping with a medical or mental health diagnosis
Family-related stress
Other
Food Allergies?
Yes
No
Please specify food allergies
Register
bottom of page
