Teen Group Work 15-17 Application Form Teen Information First Name Last Name Phone (###) ### #### Email * Birthday Age * What brings you (teen) or your child to apply to this program? * What are you (teen) or your child experiencing/ feeling? what symptoms are you feeling ? (social anxiety, nervousness, self-doubt, sadness, loneliness, depression, other)? Overall in your life how do you feel? not well so so ok alright good great What would you like to feel or what would you like to create for yourself? Thank you for sharing this with me. I look forward to meeting you. Michelle Instagram #teengroupworkshop #teengroupworkshop #teengroupworkshop
