What are some of your most powerful memorable life experience?
Note: This form is a voluntary tool designed to help us understand your experience. None of the information you share here will be used without your explicit consent, and it will never be shared with any outside sources.

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Email *
Coach's First and Last Name *
Patient's First and Last Initial *
What are some sights that when you think about them make you so happy? *
What smell(s) immediately take you to a happy place? *
Which material feels most exciting when you are physically connected to it? *
What are some of your most exciting memories around Food/Beverages? *
What are your favorite most inspirational song, music, sounds? *
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