WAITLIST FOR RECLAIM YOUR HEALTH GROUP APRIL 2023 Name * First Name Last Name Email * LOCATION (City and Country) * Why are you interested in joining this program? And can you tell me a bit more about how you are struggling? * How do you feel emotionally? Do you struggle with any big uncomfortable emotions anxiety, sadness, fear or hopelessness? * Have you had any kind of health diagnosis? Or do you have chronic symptoms that are unexplainable? * How do you want to feel? What would be your ideal outcome if we were to work together? * What would it mean for you to be free of the issues you've highlighted above? * Do you have a vision of yourself and your life without these issues? Please share what that would look like. * How do you know that you are ready for this work? * Thank you!