Happy Science Free Counseling Signup

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for reaching out to Happy Science!

Please enter your details in the form below to signup for a free counseling session.

We will reach out to you and together let's arrange a date and time for our first session.

Name *

Email *

Phone number *

Briefly, please tell us why you have reached out to us today.

Welcome to Happy Science! Where would you like to start?

Check any number of the boxes in the section below. These are optional so you may also just skip to the bottom and submit your form.

Conquer Negative Thoughts

I envy other people's success

My enthusiasm is completely gone

I live in constant fear of being hurt

I feel trapped in the past

People don't trust me

I don't have confidence in my intelligence

I have high aspirations, but they feel impossible to reach

I can't stop thinking pessimistically

Other:

Family & Relationships

I don't think my partner loves me

My children are not doing well in school

How do I deal with a combative family member?

Other:

Work-Related Issues

I'm always busy and have no time

I have poor negotiating skills

I don't get along with my boss

I don't know how to handle a demotion

My business is on the verge of bankruptcy

Other:

Spiritual / Supernatural

I'm scared of dying

I am grieving the loss of a loved one

I can't sleep (nightmares / sleep paralysis)

I may have been abducted by aliens

Other:

Health

I envy other people's success

I always feel drained.

I have a health issue or I am caring for someone with a health issue:

Other:

Lastly, what's keeping you from being happier right now?

How did you find out about us? *

I understand that submitting this form is giving Happy Science permission to contact me. *

Yes

Required

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Happy Science. Report Abuse

Forms