Clone of Excavating the Burden Discovery Questionnaire

1

First off, what's your email address?* This field is required.

example@example.com

2

Great, and what's your name?* This field is required.

First Name

Last Name

3

Are you level one IFS trained?* This field is required.

Yes

No

4

Do you identify as Latinx/o/a?* This field is required.

Yes

No

5

What are you looking to receive from the group?* This field is required.

6

What are you looking to offer the group?* This field is required.

7

What are your preferred pronouns?* This field is required.

8

Do Fridays, 12:00 - 1:30pm ET work for you?Bi-weekly meeting dates, every Fridays at 12:00-1:30pm ET starting March 6, 2026

Yes

No

9

Choose your payment plan

Single Payment: $600

2-Month Payment: $310 monthly