Main FormFull NameDOBDo you live in the state of California? Yes NoCell PhoneDo we have permission to text and call you? Yes NoDo we have permission to text and call you? Yes NoWhat is your ethnic background? (We'd like for this to be a short answer response)How did you hear about Rooted Resistance?What do you hope to gain from this group?What support are you needing right now?Have you been in therapy before? Yes NoHas White supremacy affected you in the following areas ? (Check all that apply) Emotionally Mentally Cognitively (focus, decision-making, etc) Interpersonally (relationships-work, romantic, friendships, etc)Submit