Home Our Services Tele-Transition Prog... Tele-Transition Prog... Register Interest Tele-Transition Program 1Registrant2Participant3Screening Registrant InformationYour name* First Last Phone*Email* Are you the person who would participate in the Tele-Transition Program? (The participant) Yes No Are you the participant's parent or guardian? Yes No Participant InformatonThe participant is the person who will be attending Tele-Transition Program sessions.Full Name First Last Date of Birth* Day Month Year Preferred pronouns* She/Her He/His They/Them Is the participant currently receiving services from Therapy Focus?* Yes No No, but they have previously Parent/Guardian* First name Surname Emergency contact* First name Surname Relationship to participant* Phone* Pre-Program Screening QuestionsIs the participant able to follow written and verbal instructions in a group setting?* Yes No Has the participant taken part in a group therapy session previously?* Yes No Does the participant have access to a computer or tablet?* Yes No Is the participant able to independently access a computer?* Yes No Does the participant have the computer skills to follow a link and use a search engine?* Yes No What do you / the participant hope to gain from the program?NameThis field is for validation purposes and should be left unchanged.
