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Recovery Blueprint Support Application

Recovery Blueprint Support Application

Your information is 100% confidential (we have invested in HIPAA compliant software to protect you).  Please take your time and answer thoughtfully.  The more detail you give, the better we can get to know you, and help you once you're in our group.  If you're having problems clicking "Next" and using a mobile device, write your answers and then gently swipe up and then click the next arrow for the next question
21Questions

HIPAA

Compliance

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    So we can recognize and correctly add you in our chat group. We will not contact you for any other reason.
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    So we can let you know your application status via email (we will not add you to any mailing lists or contact you for any other reason).
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    Please be as detailed as possible.
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    Please be specific.
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    Check all that apply
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    Check all that apply
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    Be as detailed and specific as possible
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    Practitioners, programs, courses, retreats, supplements, etc.
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    What's blocking your from getting better?
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    Be as detailed and specific as possible
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    Be as detailed and specific as possible
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    Be as detailed as possible
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