Support Group Registration

Support Group Registration — Form Fields

This registration template includes 8 fields. Register for a community support group session in a confidential and welcoming environment. Free to customize and use on ZenBuild.

• First Name (or Preferred Name) (text, required)
• Email Address (email, required)
• Phone Number (text, optional)
• Group Type (multiple choice, required) — options: Grief & Loss, Anxiety & Stress, Addiction Recovery, Chronic Illness, Caregivers
• Attendance Preference (multiple choice, required) — options: In-Person, Online Video, Hybrid
• Session Frequency (multiple choice, required) — options: Weekly, Bi-Weekly, Monthly
• How Did You Hear About This Group (multiple choice, optional) — options: Doctor Referral, Online Search, Friend/Family, Social Media, Flyer
• Anything You Would Like Us to Know in Advance (Optional) (long text, optional)