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SOAR Dove
1.
What is your name?
2.
What email address would you like to use for communication?
3.
What is your phone number? (Optional)
4.
I heard about SOAR for Women
From a friend (not a SOAR member)
From a SOAR member
At a workshop
Website
Facebook or other Social Media
Advertisement at a local business
5.
Are you familiar with attachment theory related concepts?
Yes
No
Somewhat
6.
Are you interested in attachment theory related concepts?
Yes
No
Indifferent
7.
Personal interests include (but are not limited to ...)
Sports
Art
Reading
Crafts
Mechanics
Computers
Video games
Cooking
Other
Other (please specify)
8.
This is my first time joining a women’s only group.
Yes
No
Can’t remember
9.
Topics I’d like to explore with the group include:
Profession / Career
Dating / Marriage / Relationships
Friendships
Intimate / Personal
Common interests
Anything under the sun
Other (please specify)
10.
Things that are off the table, not up for discussion ….
11.
The reason I’m joining this group is to
Share perspectives and ideas, learning from others is something I enjoy
Work through some personal issues that I’m struggling with at the moment
Everything is good, I just want to meet women and enjoy some chats
Learn more about myself using attachment concepts
All of the above
Not really sure just trying it out for now
12.
Is there anything else you’d like to share?
13.
Do you have questions that you’d like to ask Rosanne?
14.
Before I commit to joining S.O.A.R for Women I would like to schedule a :
Zoom
Phone call
In person
15.
S.O.A.R for Women occurs on the same night every month for consistency. Is there a day of the week that does
NOT
work for you?
Monday
Tuesday
Wednesday
Thursday
Friday
16.
What time of day works best for you?
Daytime
Evening
I'm flexible
