SNUG Intake Survey - Boris Lawrence Henson Foundation

SNUG Locations

Please select your SNUG location.

Would you be interested in attending individual counseling/therapy sessions if they were fully covered by your employer?

Yes
No

If yes, would you comfortable having virtual counseling/therapy sessions?

Yes
No

If no, why not?

Would you be interested in attending group counseling/therapy if they were fully covered by your employer?

Yes
No

If yes, please identify which of below topics would interest you. If there is a topic you don’t see, please write it in the other option. Check all that apply.

Other

If no, why not?

If you are open to individual or group counseling/therapeutic services, would you be interested in signing up in the next 30 days?

Yes
No

Confidentiality Disclaimer

Please note that all responses will be kept confidential and will be used only to inform us of topics beneficial to you.

Confidentiality Disclaimer

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