Please enable JavaScript in your browser to complete this form.
Mindfully Healing - DBT Group Registration
Please enable JavaScript in your browser to complete this form.
Name
*
Email
*
Phone Number
The applicant is 18 years old or older.
*
Yes
The applicant is able to attend the group weekly on Mondays from 9am to 10:30am
*
Yes
Location
Minnetonka Office
I am interested in
*
Registering For a DBT Group
Getting more information on a DBT Group
Referring a Patient/Client to a DBT Group
Comment or Message
*
Name
Register