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Fear Cure Questionnaire
Due to the number of responses Lissa is likely to get she won't be able to personally respond to every submission. We SO appreciate your taking the time and rest assured she will read each submission in full.
Each question must have a response. If one doesn't fit please use N/A.
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* Indicates required question
What’s your full name?
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Your answer
Are you willing to use your full name if your story is chosen for submission in The Fear Cure, or would you prefer to use your first name or a pseudonym?
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Yes, use my full name
I'd prefer to use a pseudonym.
I'd prefer to use a pseudonym. My pseudonym is:
Your answer
What’s your email address?
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Your answer
What’s the best phone number to reach you?
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Your answer
What’s your story?
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Your answer
If you’ve been sick, what fears, anxieties, or worries do you believe kept you from experiencing optimal health?
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Your answer
How did your body suffer?
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Your answer
If you faced scary circumstances but avoided getting ill, how did you do it?
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Your answer
What inner resources did you call upon to face those fears and find your courage?
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Your answer
Did you read any books, learn any practices, work with any practitioners, or use any healing techniques to aid you in your healing process?
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Your answer
How did your body respond to your brave life choices? If you were sick, did your health improve?
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Your answer
Is there anything else you want Lissa to know?
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Your answer
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