group-request - Behavioral Fitness

Name *

First

Last

Email *

Phone Number *

Desired Location *

Fireside, 10 minutes from JMH WC campus (maximum 6 attendees)
On-site, John Muir Hospital
Other

Duration *

How many attendees would you like to participate in this group

Selected Value: 2

*Fireside groups currently limited to six attendees. We will expand the capacity for these groups once guidelines for the Contra Costa County COVID-19 restrictions allow.

Please briefly describe your goals for this group session. What do you hope to have as an outcome based on our time spent together? We will work closely together to develop an agenda that aims to achieve your goals. *

Are there any specific topics you would like to address?

Would you like to include a meal (only available for 2, 3, and 4-hour sessions)? *

All fireside chats include complimentary coffee and tea.

Please provide any other relevant information here. Do you have a preferred date, time, or location in mind? Is there anything not listed above that would help in planning your custom group?

Request a Customized Group Session