Invitation to Participate in Medical Trauma Support Group

ONLINE GROUP

Please correct the errors described below.

Please complete this form if you are interested in this group.

You voiced interest in this group. If you would like to proceed further, please complete this form.

First Name

Last Name

Email address

Cell Phone Number:

Please choose any topics that might be of interest to you

Talking to doctors or other healthcare providers (1)

Communicating with Doctors/Healthcare Providers (1)

Legal Concerns (2)

Navigating legal concerns (2)

The cost of healthcare (3)

Finances (3)

Being fearful of talking to doctors or healthcare providers(4)

White coat Syndrome (4)

Resources in the community (5)

Navigating resources in the community (5)

Denial, Shock of it all (6)

Medical Avoidance (6)

Everything is so political (7)

Politics in Healthcare (7)

Finding Providers that look like me (8)

Cultural Humility in Healthcare (8)

Knowing what to do to stay well (9)

Education (9)

Finding a doctor or other healthcare providers (10)

Navigating Healthcare Systems (10)

Please list any other topics that would be of interest to you

Please list your availability to participate in this group (THIS is a computer-based group)

Group will meet last Tuesday in the month 6:45pm-7:45pm/$40 session

Your information will be encrypted.

Please complete this form if you are interested in this group.

Rechelle Brown, LCSW

Owner/Therapist, Soturi Counseling and Consulting, PLLC

Telephone: 214-251-4170, Fax: 214-617-0443
www.rechellebrowntherapist.com
8500 North Stemmons Freeway Ste. 1000, Dallas, Texas , 75247

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