12-Week Body Image Support Series

Please fill out this form to register for your support group. Please note: Registration works best if you use the Google Chrome browser. Internet Explorer users may experience problems or be unable to complete their registration.

Please register for only one support group.
To reduce overflow of our weekly support groups, we ask that you limit registration to one group at a time.

Please read and acknowledge these terms and conditions:
I understand that this support series is not therapy or counseling and that this is not a substitution for seeking out professional mental health support should I need it. I understand that when attending this group, it is not unusual to have some emotional discomfort. If at any point it would be beneficial for me to be assessed by a professional, I understand that the facilitator can provide me with an appropriate referral. I agree to keep confidential all participant identifying and clinical information. I understand that while the information I disclose is confidential, there are mandatory exceptions to confidentiality, such as child, elder, and dependent adult abuse and threats of harm to self or others. I agree to be in a private room during participation. I agree to not record any of our sessions. I agree to be respectful of other group members I agree that if I am experiencing an emergency situation, I will go to the nearest emergency room, call the National Suicide Prevention Lifeline at 988 or use the Crisis Text Line by texting HOME to 741741.

The group facilitator reserves the right to ask a group member to refrain from attending the group if they exhibit any of the following: Overt disrespect of others in the group. Self-disclosure of active engagement in treatment at PHP, Residential or Inpatient levels of care. Required use of a feeding tube (eating disorder support groups only). Self-expressed suicidal intent (REMINDER: if you are experiencing an emergency situation, you should go to the nearest emergency room, call the National Suicide Prevention Lifeline at 988 or use the Crisis Text Line by texting HOME to 741741.)