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2. Your Name *
3. Today's Date  *
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4. Your Age 
5. Country of Residence  *
6. What are you looking for from WTP? 
7. Please let us know something about your reasons for seeking support and anything else that you wish to share with us. *
8. Is there a particular therapist or coach you are drawn to working with or would you like a recommendation based on your situation from our Clinical Director ? 
9. For those seeking therapy only: 

Our therapists have clinics on Thursdays and Fridays. Please can you select which slots you could potentially attend.  

Please tick all that apply.  
Timezone is UK - GMT
Early Morning
Mid Morning
Lunchtime
Afternoon
Early Evening
Thursday
Friday
10. Would you like to join the mailing list for news from Feminist Flourishing School ?  - FFS is our sister business offering support for women to help manage the impacts of growing up in patriachy, both individually and in groups. 

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11. Finally - please can you let us know how you heard about WTP.
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