We’re Excited To Have You!

Application for Healthy Minds Group Therapy

Use the form below to apply to participate in a group at IPG. After filling out the form, we will follow up with you, via e-mail or phone, on the same or next business day.

Today's Date

Participant's Name

First

Last

I'm filling this request out for

Myself
My partner
My child
Other

Participant's age

Gender

Your Email

Select which group(s) you or your child are interested in joining

The Art of Secure Attachment: (Ages 21-35)
Teen Healthy Connections Group- Mondays
Teen Healthy Connections Group- Thursdays
Virtual DBT Groups (All adults)
Online Anxiety Support Group (All adults)

Click here to see more information on each group.

Tell us more about your interest in the group(s) you checked above.

Are you currently a patient at IPG?

Did Your the

You may click submit, and your application will be reviewed and forwarded to the group coordinator.