Healing Our Heroes Application
Thank you for your interest in our program.  Please fill out all questions completely.
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Email *
First and Last Name *
Phone Number *
How did you hear about this program? *
Are you a frontline worker/caregiver? *
Required
Have you been affected by the Marshall-Middle Fork fires? *
Do you live or work in Boulder County? *
If you are a frontline worker, where do you work? *
What is your position/job title? *
Please describe your position and how COVID/the Marshall-Middle Fork fires affected you and/or your work. *
Are you interested in receiving acupuncture? *
Required
Are you interested in receiving massage therapy? *
Required
Thank you. We will be in touch within the next 72 hours.
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