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• Chronic Pain Support Group

• We're so very sorry to learn that you are suffering from chronic pain. It's not uncommon for people with chronic pain to have a variety of symptoms including sleep disturbances, fatigue, trouble concentrating, decreased appetite, and mood changes.
  
  This group will explore ways to support one another, provide resources and guidance on managing your pain and speaking with your other providers.
  
  One of the greatest benefits to this group is sharing the mutual understanding of what it is like to live with chronic pain or illness.

• Wednesdays 6:30-7:30pm

• Rolling Admission

• Sessions will be conducted via Zoom

Facilitator(s): Nicole Blake, SW Intern

more info

Most insurances will cover the cost of group sessions.
Speak to our Group Coordinator for questions regarding insurance or self-pay rates.

How to Join:
To inquire further about groups, please contact our Groups Coordinator at 603-865-1321 option 3, or you can

Register for this Group

Who is completing this request? *

Please select an option Parent / Guardian Myself Service Provider

Your name
Agency name
Agency Phone Number	(do not include 1- prefix)
Agency E-Mail Adr
Is the individual aware you are referring them to this group?	Yes    No Please choose yes or no
May we contact you regarding this referral if needed?	Yes    No Please choose yes or no

Why are you interested in this group?
Participant First Name *
Participant Last Name *
Date of Birth * (mm-dd-yyyy)
Address*
Parents Name (if Client under 18)
Communication Preference	Phone    Email Please choose yes or no
Phone *	(do not include 1- prefix)
OK to Leave Message *	Yes    No Please choose yes or no
E-Mail Adr

Do you have Health Insurance ? *

Please select an option Yes I do No Insurance

Insurance Carrier *
Insurance ID# *

Secondary Insurance
ID Number
How did you hear about this Group? *
If you were referred to this Group, who referred you? *
(* required info)