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Sound Healing Research Study Waiting
Full Name
*
Email
*
City
*
State/Province
*
ZIP / Postal Code
*
Phone Number
*
Age
*
Gender
Male
Female
Gender
Gender
Gender
Male
Female
Select
Preferred Contact Method
Email
Phone
Either
Preferred Contact Method
Preferred Contact Method
Preferred Contact Method
Email
Phone
Either
Select
Do you have access to a vehicle and can get to any scheduled appointments?
*
Yes
No
Have you participated in sound healing therapy before?
*
Yes
No
If yes, please describe your experience:
Have you been affected by trauma, anxiety, or stress?
*
Yes
No
Are you a:
*
Veteran
Active Duty Military
Police Officer
Firefighter
Paramedic/EMT
Other First Responder
If other, please specify:
Do you have any medical conditions or relevant history we should know about? (Optional)
Consent (required)
*
I agree to participate in the study and provide my data as part of the research.
I agree that if accepted in the study I will complete all parts of the study, attend all scheduled sessions on time, and understand my participation is voluntary. I can withdraw at any time.
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