Registration Form

Cool, Calm and Creative: An Anxiety Skills Group for Kids

A Therapeutic Expressive Arts Group for Ages 10-13

Does your child/teen get stuck in worries, have trouble trying new things, or feel overwhelmed by big feelings? Cool, Calm and Creative is a 6-week therapeutic group designed to help children and teens understand anxiety and learn practical, creative tools to manage it.

Led by members of our expressive arts therapy team, this small-group program combines art making, playful movement, and skill-building activities to help children:

Understand how anxiety works in their body and mind
Practice calming techniques to use in the moment
Build confidence in facing challenges and trying new things
Connect with peers who “get it” and understand their struggles
Instructor: Emma Cox and Megan Barnes (ALC Graduate-Level Interns)
Location: The Artful Life Counseling Center and Studio - Beverly, MA
Day/Time: Mondays @3:30- 4:30 pm
Dates: Jan 26, Feb 2, Feb 9, Feb 16, Feb 23, March 2

Today’s Date *

Your First Name *

Your Last Name *

Primary Cell Phone *

Email *

Group Participant's First Name *

Group Participant's Last Name *

Pronouns

Child/Teen's Age *

Street Address *

City *

State *

Postal code *

Is this group participant currently a client at The Artful Life? *

Tell me a little about your interest in this group. *

What do you hope your child/teen will gain from this group? *

What is your child's experience with anxiety? *

Are there any accommodations we should be aware of? (physical, communication needs, safety concerns, etc.) *

INSURANCE

The Artful Life can accept the major insurances listed below:

Aetna
Allways / MGH
Blue Cross Blue Shield
Blue Cross Blue Shield Medicare Advantage
Blue Benefit
Fallon
Harvard Pilgrim
Health Plans, Inc.
Mass General Brigham (MGB)
Meritain Health
Tufts Commercial
Tufts Direct (Public)
Tufts Health Together (Public)
UMR
Unicare GIC
United Healthcare
Wellpoint
WellSense
Private Pay

We are NOT able to bill Medicare, Medicaid, Masshealth, Steward Health, Tricare, & Cigna

*Please note that most insurance plans DO NOT cover two behavioral/mental health services on the same day. If you are receiving other mental health services—either within this practice or at another program—on the same day as the group, please contact your insurance provider to confirm coverage.When using your insurance, you will be responsible for paying any copays/deductibles as determined by your insurance provider*

What is your Primary Insurance Provider? *

Insurance Plan Name *

Member ID *

Please Upload the front and back of your insurance card here

I understand that The Artful Life does NOT bill out-of-network insurances. *

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