Every thing we do is with you - Gay, Lesbian, 

Bisexual, amd Transgendered Persons - in mind. 

                  Couples Services |Telephone Services | Workshops | Quick Advice | Sessions           

 

Registration                                If you prefer to print/fax/mail registration click here

Step 1:  Complete Registration Form  | Step 2:  Make Payment  | Step 3:  Receive Confirmation
 

PARTNER ONE

PARTNER TWO

Name         

Name         

 E-Mail        

E-Mail         

Address       

City|St |Zip 

Phone           

Address       

City|ST  Zip 

Phone         

RELATIONSHIP STATUS

How would you describe the current status of your relationship?  Including the length of time you've been together?

SELECT YOUR WEEKEND 

September 29th and 30th, 2007

February 2, 3 2008

May 24, 25, 2008

QUESTIONS/COMMENTS

Is there anything else you would like to share that will be helpful in my working with you?

Payment Options

Call with Credit Card (317)517.0065 - Leave Confidential Voice Message
Utilize PayPal (If you check this, you will receive a request for payment with a link to pay)
Mail Check to:  Michele O'Mara, LCSW

Print and Mail or Fax registration (download form here)

                6450 West 10th Street, Suite 7

                Indianapolis, IN 46214

How did you Hear about The Weekend?