Heart-Mind Fitness Training                                  Workshops Waitlist
Online Group Coaching
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Which workshop(s) are you most interested in? *
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Client Full Name *
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Phone number (including area code) *
Time Zone *
Availability to attend online workshop (Using above time zone) *
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Date of Birth (if under 18 years of age)
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Main Topics of Interest *
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Why are you interested in taking this (or these) online workshop?  Lead with your chief complaint (I.e. Career change, poor communication in relationship, needing deeper conflict resolution.) *
If there is a corresponding retreat for the workshop you are taking, would you be interested in attending? *
Have you ever received traditional therapy or life-coaching on this topic before? *
What was the outcome? What worked?  What didn't? *
Are you interested in email articles, blogs or social media posts on this topic? *
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