About You

First Name *

Last Name *

Email Address *

Phone Number

Your Relationship to the Participant *

About the Participant

Participant First Name *

Participant Age *

Brief Description of What You're Hoping to Work On

What You're Interested In

Select all that apply

Summer Intensive (July 6–30 · Ages: Adolescents) Children's PEERS® (ages 8–11) Adolescent PEERS® (ages 12–17) Young Adult PEERS® (ages 18–28) Individual therapy Family therapy Parent coaching Not sure — I'd like guidance

How Did You Hear About Us?

Referral Source

Anything Else?

Additional Notes (optional)

Submitting this form does not guarantee placement. We'll contact you to confirm availability and next steps.

We'll review your inquiry within 1 business day.

You'll receive a call or email to discuss fit and placement.

We'll confirm your spot and send enrollment details.

See you at the first session!

Now enrolling — Fall 2026

No diagnosis required

A formal diagnosis is not required to enroll in PEERS® classes. Motivation matters more.

Small groups

Groups are capped at 5–8 participants so everyone gets real attention and practice time.

Flexible options

Can't make it in person? Therapy and parent coaching are available via telehealth for MN residents.

Ready to get started?

No diagnosis required

Small groups

Flexible options