UPLIFT-COUNSELING Email Marketing -

Group Interest | A New Life: Divorce Support

Please answer all questions below.

Full Name

Email*

We are offering both virtual and in-person options. Which one do you prefer? *

Here are the 6 different weekly themes of the group:

Are these group topics and themes what you are looking for in group support? *

Yes, exactly!

Not sure.

All group members are required to commit to all 6 weeks of group, this allows for a strong cohesive group and best outcomes for you. *

Since we require commitment to all 6 group sessions, there will be no refunds or adjustments for any missed sessions.

Yes, I understand.

I'm not sure about this.

This group is specifically for South Asian/Muslim that are already divorced/separated or are in the process of getting divorce/separation.

Yes, I'm a South Asian and/or Muslim woman

I am in the process of getting divorced

I am already divorced

What are you hoping to achieve by joining this group? *

We offer two payment options for group. Which one do you prefer?

Weekly $50 - Total $300 over 6 weeks

Pay in full upfront with a discount of $30 OFF - $270

We will review your form and if your goals are a good fit for our group, we will contact your for further instructions on registration. Keep an eye out for an email from us

Yes, I understand

I have questions about the group