Group Coaching Sign Up Form

Please compete the form below to sign up for Group Coaching.

Upon receipt, I will send you an invoice. Once paid, you will gain access to our members area.

First name

Last name

Phone

Are you interested in completing the 10-week Resilience and Empowerment After Loss education and group coaching program?

Which option would you choose?

Option 1: Mondays 7:00 to 8:00 pm (March 24 to June 2, 2025)

Option 2: Tuesdays 7:00 to 8:00 pm (March 25 to May 27, 2025)

What do you hope to achieve by completing the course and 10 week coaching program?

Are you committed to attending all group coaching sessions to the best of your ability? (Keep in mind we do realize that sometimes there are circumstances that are out of our control.)

This group provides coaching and support and is not a substitute for professional counseling. Please write in the word "Yes" to indicate you understand this.

Do you agree to maintain confidentiality within and outside of the group?