Go With The Flow/Befriend Your Feelings

Thank you for your interest this group! Please complete this form so we can learn more about your child. We will review the information to ensure the group is a good fit, and then follow up to finalize registration.

Please note that information collected on this form will be kept confidential and will not be shared with others outside of our practice.

Child's first name

Child's last name

Child's date of birth

Parent/guardian last name

Email address

Phone number

Which group program(s) are you registering for?

Befriend Your Feelings Tues @ 5pm (September 29th to November 3rd)

Go With The Flow Tues @ 5:45pm (September 29th to November 3rd)

Befriend Your Feelings Wed @ 5pm (November 11th to December 16th)

Go With The Flow Web @ 5:45pm (November 11th to December 16th)

Please tell us a little bit about your child and why this group might be a good fit.

Please feel free to share any important information about your child's health, development, and any diagnoses (e.g., ADHD, Learning Disability, Autism).

Each session of this group is 45 minutes long and will involve some listening and learning, as well as fun and engaging activities. Do you have any concerns about your child’s ability to participate in this type of group?

Has your child previous attended any group programs or services at Riverwise, and if so which one(s)?

Do you have any questions about this group?

Your information will be encrypted.

Go With The Flow/Befriend Your Feelings

Thank you for your interest this group! Please complete this form so we can learn more about your child. We will review the information to ensure the group is a good fit, and then follow up to finalize registration.

Thank you for your interest this group! Please complete this form so we can learn more about your child. We will review the information to ensure the group is a good fit, and then follow up to finalize registration.

Riverwise Psychological Services