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Group Counseling Registration form

Please fill in your personal details

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Organization Name

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Desired Date:

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Time and Duration:

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Preferred Mode:

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Preferred Mode:

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Online

B

Offline

Focus Area Or Topic of Interest:

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Participant Demographics

Age Range

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Job Roles

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Any specific concerns or challenges the group is facing?

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Additional Information

Any preferred counseling techniques or approaches:

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Goals or objectives for the counseling session:

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Any additional comments or questions:

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Preferred mode of contact?

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