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Intentional Wellness Support Group Registration
Welcome to the Intentional Wellness Support Group registration form! This group is designed for individuals who want to grow together in intentional wellness by reading through the 'Intentional Wellness' book and meeting virtually once a week for accountability. Please complete this short form so we can prepare for our kickoff session. Thank you for your interest — we look forward to creating new habits together!
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Full Name
Please enter your first and last name.
Your answer
Email Address
Enter your preferred contact email for group communication and virtual meeting links.
Your answer
Have you participated in any wellness or self-improvement groups before?
We’d love to understand your past group experience.
Yes
No
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Preferred Kickoff Date
Choose your preferred start date for the kickoff call.
January 4
January 11
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How did you hear about the Intentional Wellness Support Group?
Let us know how you found out about our group.
Social Media
Friend or Family
Email Newsletter
Website
Other
Have you purchased the 'Intentional Wellness' book?
This book will be used throughout the group sessions.
Yes, I have purchased it.
No, but I plan to purchase it.
Not yet, please send me the link.
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Where would you prefer to purchase the book if needed?
If you haven’t purchased the book yet, please select your preferred site. This will be shipped to your doorstep 🫶🏾
Amazon
https://a.co/d/iU9XESD
Official Author Website
https://www.pureandsimple-fitness.com/product/intentional-wellness-paperback/
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How excited are you to join this Intentional Wellness journey?
On a scale from 1 to 10, please rate your excitement level.
1
2
3
4
5
6
7
8
9
10
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Any additional comments or questions you’d like to share?
We appreciate your thoughts and feedback.
Your answer
We are so excited to go on this journey with you!!
Your answer
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