Header Image
SBF SUPPORT GROUP NEW MEMBER REGISTRATION FORM

If you have never attended an SBF Support Group, please fill out the following registration form.
The Social Butterflies Foundation provides support groups for two reasons:
1. To assist and support group members in developing skills in coping and living with a chronic illness.
2. To foster open discussion of how lupus and fibromyalgia affects our lives and assist members in developing self-management skills.

A support group is not designed to provide professional psychotherapy or counseling. Social Butterflies Foundation (SBF) Support Group facilitators have a desire to help others. All facilitators have received training by a professional in how to provide support in a nonthreatening environment. Some are trained professionals. Although this is not a therapy group, out of respect for participants, confidentiality is a must. All information and dialogue are confidential and shall not be discussed or revealed outside of the group.

The opinions and statements expressed by the group members or its facilitator do not necessarily reflect the opinions or positions of the Social Butterflies Foundation or its affiliates.

SBF, the support group facilitator, nor support group members shall share support group member information with outside organizations, companies, the media, or individuals. Member contact information will only be used to notify an individual of any changes to future support group meeting times and location unless members choose to join the SBF mailing and e-mail distribution list.

Name *
First Name
Last Name
Email *
Address *
Address Line 1
Address Line 2
City
State
Zip
Phone *
Date of Birth *  
Wedding Anniversary Date  
Gender *  
Ethnicity *  
Active Duty Military *  
What branch of military if Active Duty  
Are you a US Veteran *  
What branch of the military if a Veteran  
What is your connection to lupus or fibro *  



Agreement to maintain confidentiality of members *  

Although this is not a therapy group, out of respect for participants, confidentiality is a must. All information and dialogue are confidential and shall not be discussed or revealed outside of the group.

Thank you for completing the New Member Registration Form! We welcome you!

"Butterflies don't let each other fly alone" ~ Chastity Corbett, Founder & C.E.O