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Please review the following services and indicate your interest (check all that apply):
Stress Management Basics Workshop
Advanced Stress Reduction Techniques
Mindfulness and Meditation Sessions
Physical Wellness for Stress Relief
Nutrition and Stress Management
One-on-One Coaching Sessions
Group Support and Discussion Circles
Corporate Stress Management Programs
What are your primary reasons for seeking stress management services?
Work-related stress
Personal or family-related stress
Health concerns
General well-being improvement
Other:
How would you rate your current stress level?
Low
Moderate
High
Very High
Have you previously attended stress management workshops or similar programs?
If yes, please describe:
Do you have any medical or mental health conditions that may impact your participation?
If yes, please specify:
Are you currently under the care of a healthcare provider or therapist?
If yes, please provide details:
What are your goals for attending this workshop? (Check all that apply)
Learn relaxation techniques
Improve time management skills
Build resilience to stress
Enhance physical health
Connect with others experiencing similar challenges
Other:
Do you have any preferences for the format of the workshop?
In-person
Virtual
Hybrid
No preference
Are there any specific topics or techniques you would like to focus on?
Do you have any accessibility needs or accommodations we should be aware of?
If yes, please specify:
I understand that the information provided in this form will be kept confidential and used solely to tailor the workshop to my needs.
I acknowledge that these workshops are educational and not a substitute for professional medical or psychological treatment.
I give permission to be contacted regarding workshop details, follow-ups, and related services.
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