Application for Men’s Online Trauma Informed Recovery Coaching Group Please enable JavaScript in your browser to complete this form.Name *Email *Phone Number *Is it appropriate to leave a specific message at this number?YesNoAre you (please select):MarriedSeparatedDivorcedSingleCo-HabitatingOrientation (please select):BisexualGayStraightTransOtherBriefly describe your recovery journey to this day in ten sentences or less. Be brief… less is more! *Tell me why you think that this is the right time in your journey to enter this Men's Group Recovery Coaching? *Are you currently attending a 12-step program or any other form of group support for recovery? Please describe in 5 sentences or less. *Are you currently seeing a Mental Health professional for recovery counselling?YesNoDo you have a primary medical physician?YesNoAre you ready to recover yourself? YesNoCommentSubmit
