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Joshua Group Intake Form

This specialised intervention program is designed for men who have perpetrated family violence and are committed to changing their behaviour and taking responsibility for their actions. The program focuses on developing accountability, understanding the impact of violence on families, and building healthy communication and relationship skills. Through evidence-based therapeutic approaches, participants work to identify triggers, develop emotional regulation strategies, and learn non-violent conflict resolution techniques. Our goal is to support genuine behavioural change while prioritising the safety and well-being of families and communities. By completing this form, you are taking an important first step toward accountability and creating positive change in your relationships.

Marital Status

Gender

Occupation

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Academic Background

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Mental Health
Medical Health
Admission to Sandilands Rehabilitation Centre
Yes
No

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Do you currently have a history of drug usage?
Do you have a history of drug usage (in the past)?
Have you abused anyone?

_______________________________________________________________________

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