Observation Intake Form

The Brookline Center invites Boston-area clinicians to observe and learn from our most seasoned group therapists in this enriching professional development series.
  • Questions

  • Date Format: MM slash DD slash YYYY
  • Payment Information

  • Checks: Please address checks to the Brookline Center for Community Mental Health. In the memo section please write Observation Group – Observer. Checks can be mailed to 41 Garrison Road, Brookline, MA 02445.
  • Credit Card: To pay by credit card, please call the admin office at (617) 277-8107 and ask to pay for the Observation Group.
  • After submitting an application, the adult group program manager will be in touch with you to confirm your identity, credentials, and possible start date for observation. Please know that remote observers will need to provide photo confirmation of their identity (e.g., photo of driver's license) and current professional license (e.g., photo of licensing card).
  • This field is for validation purposes and should be left unchanged.