JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
MindGrapher ™ Release Interest
We are now collecting information for those interested in MindGrapher ™. If you are interested, please complete this form below.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name: First and Last
*
Your answer
Complete Address
*
Your answer
Email
*
Your answer
Phone Number
*
Your answer
Profession
*
Psychologist
Psychiatrist
Social Worker
Counselor
Behavior Analyst
Other:
What is the number of clients you work with annually? (specify a number)
*
Your answer
Do you have experience with using daily diaries or ecological momentary assessment in your clinical work?
*
No
Very little
Some
A lot
Rate your knowledge of process-based therapy (PBT)?
*
None
1
2
3
4
5
A lot
Describe your type of clinical practice, its setting, and type of clients served
*
Your answer
Describe the types of interventions you use:
*
Your answer
Why are you willing to be part of this beta?
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Institute for Better Health.
Report Abuse
Forms
