DBT Class and Group Online Registration

January DBT Advanced Process Group 18+ (Registration open)
 

$280 | The DBT Advanced Process Group will start on 1/7/2020 and will be held weekly on Tuesdays from 1:30pm - 3pm moving forward. As this is an ongoing group, participants must register monthly and on the first of the month for continued attendance.  See requirements before registering.  

Emotion Regulation DBT 8 Week Skills Class (Online Registration Closed)
If you attended the previous skills class, please register at the office. 
 
Participants With Peachtree DBT Therapists 
$705 ($680 early bird) | Registration for participants with Peachtree DBT therapists will close 2/7/20. Early bird available until 7/24/20.
 
Participants With Outside Therapists
$760 | Registration for participants with outside therapists is currently closed. A case management fee ($80) is included for weekly communication and dialogue between the class instructor and outside therapist. Participants with outside therapists are required to complete and return outside therapist paperwork prior to the start of class. 
 
 
Patient Information
If participant is under 18, name of parent or guardian.
Name of participant's current individual therapist within Peachtree DBT or within the community. Additional forms will be requested for those participants with a therapist within the community.
Participants with outside therapists are required to complete and return outside therapist paperwork prior to the start of class. Participants with outside therapists cannot attend class without completion of outside therapist paperwork.  
Optional. If the participant's phone is different than the payer's.
If participant is a student, please enter the school or university where he/she is currently enrolled.
Please note participant's grade level if applicable.
Class Type and Preferences
Please select the class you wish to attend.
Please select the class(es) to attend. Remember that the mindfulness seminar is required for participants who have not attended a past DBT skills class.
Payment Details
Person who will be submitting payment
$
For the 8 week DBT Skills Class: If the patient's therapist is not a part of Peachtree DBT, there is an additional fee ($80) due to weekly correspondence and case management between the DBT class instructor and primary therapist.
I agree and consent to participation and the terms and conditions. I understand my registration will not be complete until payment is received. I also understand and agree that if I miss any or drop out of class for any reason, I will not be reimbursed.
Reminder
Participants with outside therapists are required to complete and return outside therapist paperwork prior to the start of class. Participants with outside therapists cannot attend class without completion of outside therapist paperwork.  
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