Hi client ,
I look forward to meeting you at the group informational consult!
Thank you for filling out the questions below so I can learn a little about you before you attend the consult.
Birthday {"type":"text","name":"age","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":"Month/Day/Year"}
Age
{"type":"text","name":"age2","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":"Age"}
Time Zone
{"type":"text","name":"age3","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":"Time Zone"}
Group Interest
Young Adulting with ADHD ( ages 18- mid 20's) Foundations for Adulting with ADHD MOMENTUM (Accountability Monthly Membership) Women/Men Support Group Power Sessions (Virtual "Adult Study Halls") {"type":"checkbox","name":"__generic","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please make a selection for this item.","options":"Young Adulting with ADHD ( ages 18- mid 20's)\nFoundations for Adulting with ADHD \nMOMENTUM (Accountability Monthly Membership)\nWomen/Men Support Group \nPower Sessions (Virtual \"Adult Study Halls\")"}
What are some of your main challenges? {"type":"textarea","name":"strugglingWith","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":"A few words or sentences will do! Up to you, no need to organize your thoughts!"}
What is motivating you to take action to get help right NOW?
{"type":"textarea","name":"strugglingWith2","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":"A few words or sentences will do! Up to you, no need to organize your thoughts!"}
Have you had any previous/current ADHD focused therapy or coaching to help with your challenges?
{"type":"textarea","name":"__generic2","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":"A few words or sentences will do! Up to you, no need to organize your thoughts!"}
Is there anything else you want us to know?
{"type":"textarea","name":"__generic4","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":""} How did you hear about us? ( please be specific, thank you!! )
{"type":"textarea","name":"__generic5","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
Congrats on taking this first step! See you soon! -Lisa
During this free phone consult, you can tell us more about your situation and we can tell you about the different types of groups and workshops we offer throughout the year.