Hi!

I am very excited to have a chance to connect with you and talk about the possibility of you joining the Reclaiming Wholeness group. Once you complete this form and submit it, I will reply to you within 24 hours so we can set up a time to connect. In the meantime, you can always reach out to me via my contact page.

Name

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Address

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Tell me a little bit about why you'd like to join this group:

Have you done any previous healing work for this? Tell me a little bit about what you've done:

Do you have any questions you'd like to ask me?

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Thank you for taking the time to complete this. I will be in touch soon!