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Email
Your answer
Name
Your answer
Address
Your answer
City
Your answer
State
Your answer
Zip code
Your answer
What is your relationship in the healing profession?
-License (LMFT, LCSW, Psychiatrist, Psychologist, Reiki Master, Hypnotherapist, Coach, etc.)
Your answer
How long have you been actively working within your field of endeavor?
Your answer
What is foremost within your Psyche when you accept a client?
Your answer
Have you ever been in therapy?
Yes
No
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From your perspective, when is one deemed psychologically healthy?
Your answer
What would you like to gain from this program for Healers?
Your answer
What is special about you as a professional?
Your answer
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