JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
EVENT REGISTRATION
MOVING FORWARD RECOVERY COACHING GROUP
November 12 - December 17, 2019
6:00 - 7:45 pm
Johnstown Public Library 38 S Market St, Johnstown, NY 12095
Contact us at 518-417-2154 or
recoverycoachingservices@gmail.com
This is a free six week event
Sign in to Google
to save your progress.
Learn more
* Indicates required question
What is Recovery Coaching?
Name
*
Your answer
Email
Your answer
Have you heard of Recovery Coaching?
Yes
No
Clear selection
What stage of Recovery are you in?
*
Awareness and Early Acknowledgement
Consideration
Exploring Recovery
Early Recovery
Active Recovery and Maintenance
How long have you been in recovery?
*
Your answer
3 Most Important things you are seeking help for
Your answer
2 Areas in your life that you would like to move forward in terms of personal growth
Your answer
Are you currently attending a support group?
*
Yes
No
Other:
How do you best learn?
*
Visual
Auditory/Hearing
Reading/Writing
Hands On/Doing
How did you hear about us?
*
Church
Flyer
Friend
Meetup
Facebook Event
Other
Would you like someone to contact you?
Yes
No
Clear selection
If yes please leave your number
Your answer
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
Forms
This content is neither created nor endorsed by Google.
Report Abuse
Terms of Service
Privacy Policy