CMHA Rosetown Parent Support Group Registration

This group will meet the first and third Thursday of the month, 6:30-8 p.m. (unless otherwise specified). Pre-registration must be completed with your current email address so that we can send out reminders.

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* 1. Your name (First, Last)

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* 2. Email address

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* 3. Cell phone number

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* 4. Preferred Pronouns (she/her, he/him, they/them)

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* 5. Age

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* 6. Mailing address

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* 7. Number of children and ages

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* 8. What parenting concerns/topics would you like to discuss in this group (eg. sleep issues, self-harm, depression, school avoidance)?

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* 9. How did you learn of our Parent Support Group?

I was contacted by CMHA Rosetown

CMHA Rosetown Facebook Page

CMHA Rosetown Instagram

Mental Health Professional/Counsellor

RCHS School Newsletter

RCHS Facebook Page

WAS School Newsletter

WAS School Facebook Page

Rosetown Events and Activities Facebook Page

Town of Rosetown Website

Word of Mouth

Other (please specify)

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* 10. How often would you like this support group to meet?

Once a month

Twice a month

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* 11. Would you be interested in presentations from psychiatrists, counsellors, pharmacists, or other mental health professionals as a part of Parent Support Group? If yes, please comment in detail who you would like to present and what topics.