Thank you for submitting the form below. Please complete the * sections to provide the confidential information needed to complete your registration. The rest of the questionnaire is optional, however, your willingness to complete it will help me know you better as you embark on this journey. If you are registering as a couple, please have each person complete a questionnaire. Your participation in the workshop/group will be confirmed upon the receipt of your down payment along with the submission of this Questionnaire and the Informed Consent Form.