Trauma Healing Interest Form

Are you interested in attending a Trauma Healing Group?

Please fill out this form; note that filling out this form only expresses your interest in participating in a Trauma Healing Group, it does not commit you to joining a group. After you submit this interest form, we will contact you with more information about future groups happening and answer any questions you may have.
Name*

First NameLast Name
Church or Ministry Name*
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
Phone Number*

Area CodePhone Number
How did hear about Trauma Healing?
What time of day works best for you to attend a group? (check all that apply)

MorningAfternoonEvening
What day(s) of the week work best for you to attend a group? (check all that apply)

SundayMondayTuesdayWednesdayThursdayFridaySaturday
Would you rather attend a Trauma Healing Group

OnlineIn personNo preference
Type a question

Type option 1Type option 2Type option 3Type option 4
If you prefer an in person group, what area of the Twin Cities do you prefer to meet?

North MetroSouth MetroWest MetroEast MetroOther
What questions do you have?
Should be Empty:

Are you interested in attending a Trauma Healing Group?