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* 1. I am interested in learning more about a Virtual (online) Women's Wellness Workshop!

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* 2. I would be interested in a Virtual Workshop because...(choose any or all)

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* 3. The best time for this workshop according to my schedule would be:

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* 4. I would like the following to be included in the cost of the Virtual Wellness Workshop. Choose any that apply.

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* 5. I would be willing/able to invest the following amount for (3) Group Sessions, (1) individual group session with Lisa, a Facebook Page and other videos/podcast and material per month.

35.00 55.00 75.00
i We adjusted the number you entered based on the slider’s scale.

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* 6. How would you like to receive additional information about Workshop ?

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* 7. Other comments you would like to share with Lisa

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