Healing Our Heroes Application
Thank you for your interest in our program. Please make sure you fill out all questions completely.
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Email *
First and Last Name *
Phone Number *
How did you hear about us? *
Are you a frontline worker/caregiver? *
Are you a family member/friend of an employee of King Soopers on Table Mesa in Boulder? *
Are you a family member/friend of a victim of the March 22nd Boulder mass shooting at King Soopers? *
Are you a resident of Boulder or Broomfield County? *
Do you work in Boulder or Broomfield County? *
Where do you work? *
What is your position/job title? *
Please describe your position and how COVID/the recent mass shooting in Boulder has impacted you and/or your work. *
Are you interested in receiving acupuncture? *
Are you interested in receiving massage therapy? *
Thank you. We will be in touch within the next 72 hours.
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