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Family Healing Room Intake & Registration Form

Thank you for your interest in The Family Healing Room!

The Family Healing Room is a faith-centered, group-based program that brings multiple families together to learn, reflect, and grow in community. Designed for parents and adult family members, it provides practical tools to strengthen relationships, improve communication, and foster lasting healing at home. All group sessions take place virtually via Zoom, where trained Family Healing Room coaches guide participants through each lesson and activity.



The Family Healing Room is not therapy, and while it is designed to support growth and connection, it is not a replacement for therapy, counseling, or medical or crisis care; we encourage participants to seek additional professional support when needed.
 

If you’re interested in joining, please complete the following form. Your responses will help us understand your family’s needs and determine whether The Family Healing Room is the right fit for you.


 
This question requires a valid date format of MM/DD/YYYY.
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This question requires a valid email address.
This question requires a valid email address.
10. Full Mailing Address (for mailing of Family Healing Room workbook for each participant) *This question is required.