Weekly Check In
This is a weekly check in form for the Healing Relationship Trauma program.  All answers will be strictly confidential with Joshua Wagner
Sign in to Google to save your progress. Learn more
Email *
Name 
Did you have any major achievements this week?
Are there any milestones reached that you would like to highlight?
What challenges have you faced this week and how have you addressed them?
Are there any persistent issues that continue to hinder your progress?
Do you have the resources and support to continue to move forward effectively?
How can the group or I assist you in moving forward this week?
What are your primary goals for the  upcoming week?
Are there any obstacles or difficulties you need to prepare for?
What positive opportunities lie ahead for you this week?
Did you listen to the Hypnosis Track from our last group session at least twice?
Clear selection
On a scale f 1-10 how would you rate your current morale and motivation this week (10 being really good!)
Clear selection
Is there anything I need to be doing better?
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report