Healing After Sexual Assault
[This group is currently full. Please fill out form below to sign up for the waitlist.]

This group requires a pre-screen appointment. By submitting this form, you are expressing interest in attending the group. You will need to contact CAPS by stopping by the CAPS Main Office or calling (805) 893-4411 to schedule your pre-screen appointment.

Date/Time: Friday, 1:00-2:30pm
Location: Gaucho Support Center - Isla Vista
Leader: Liz May, Ph.D.
This group is designed to provide a supportive and safe environment for female-identified students who have experienced sexual assault as an adult.
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Perm Number *
Phone Number
Can we leave a voice message at the phone number provided?
Clear selection
Comments
By checking below, I understand that I need to contact CAPS to schedule a pre-screen appointment before I am officially registered to attend this group.  If I have any other questions, I will call CAPS at (805) 893-4411 or email the group co-leaders. *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of University of California, Santa Barbara. Report Abuse