Emotional Fitness Group for Men

Emotional Fitness Group

The group may consist of 3 - 6 men with ages ranging between 20s - 50s. It is a combination of an educational and support group that requires a workbook.

The purpose of the group is not necessarily focused on "anger management" but rather on overall emotional health- and how it connects with relational and spiritual health. A 50-minute intake session with the facilitating therapist is required before registration can be completed.

Dates:	8 consecutive weeks on Thursday evenings 6-7:30PM Beginning September 7th 2023
Where:	Center for Relational Care 970 Woodstock Pkwy., Suite 210 Woodstock, GA 30188
Cost:	1 hr intake session at $100 $50 per group session $10 required workbook

Name*

First NameLast Name
Preferred Name:
Date of Birth*

MonthDayYear
Relationship Status:*

SingleSeparatedMarriedWidowedEngagedIn a RelationshipDivorced
Primary Phone Number*
Please enter a valid phone number.
Primary Email Address*
example@example.com
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How did you hear about this group?*
What made you interested in this group?*
What do you hope to gain from being a participant in the group?*
On a scale from 1 to 10, how comfortable do you currently feel about sharing your emotions, thoughts/opinions, and life experiences in a group setting?*

1

2

3

4

5

6

7

8

9

10

1 is Not at all Comfortable, 10 is Very Comfortable
Please briefly explain.*
On a scale from 1 to 10, how comfortable are you with receiving care, comfort, attention and support from others?*

1

2

3

4

5

6

7

8

9

10

1 is Not at all Comfortable, 10 is Very Comfortable
Please briefly explain.*
Have you ever had counseling or psychotherapy (ex. individual, couple, family or group)?*

YesNo
Is there anything you would like the group facilitator to know about your background?*

YesNo
Please explain.*
If there is enough interest to potentially add another group, is there a specific day (Mon-Sat) and time of the day (Morning 7am - 10am, Midday 10am - 1pm, Afternoon 1pm - 5pm, Evening 5pm - 7pm etc.) that may work best for you?
Thank you for registering for the Emotional Fitness Group for Men! Registration is not finalized until you complete a 50-minute intake session with Ryan O’Kelly, LPC. Ryan will contact you within 5 business days in regards to scheduling the intake session. If you have any questions or need assistance, please contact our office at 678-653-3272.
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