Interest Form

Thank you for your interest in Safe Harbor. This brief form helps ensure the group is a good fit for you and that expectations are clear.

1. Name (First name is sufficient) *
2. Email Address *
3. What drew you to Safe Harbor? (Share as much or as little as you’d like) *
4. What are you hoping to get out of this space? (There is no right answer) *
5. Safe Harbor is a facilitated peer-support and emotional processing group, not group therapy. Please check the boxes to confirm you understand: *	I understand this is not therapy I understand the facilitator is not acting as a therapist I understand this group does not replace individual therapy or crisis services
6. Which statement best describes you right now? *
7. Is there anything you want the facilitator to know to help support safety or inclusion in the group? (Optional)
8. Do you currently have support outside of this group? (This could be friends, family, therapy, community, or other supports) *
	9. Crisis Resources Acknowledgment — I acknowledge that if I need immediate crisis support, I can call or text 988 (Suicide & Crisis Lifeline) *

Your privacy matters. Details you share here are confidential. We’ll reply with next steps and scheduling options.

ASK@SAFEHARBORFM.ORG

2026