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Registration for Upbeats
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Email
*
Your email
Untitled Title
Preferred method of contact?
*
Your answer
Phone
*
Your answer
Preferred first and last name
*
Your answer
Pronouns (optional)
She/her/hers
they/them/theirs
Prefer not to say
Other:
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Age (optional)
Your answer
Musical experience (if any; none required to participate)
Your answer
How did you hear about UpBeats?
I have participated before
Social media
An online resource
Through someone I know
Through a healthcare provider I know
Other:
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If you learned about UpBeats from a source not listed please comment below
Your answer
Optional: Is there anything that you would like to personally focus on as part of joining the group. For example anxiety, social needs, emotion regulation, other.
Your answer
Optional: Is there anything that you would like to ask facilitators or share?
Your answer
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