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Therapeutic Touch® Practice Group Registration October 25th, 2024

Thank you for registering - we look forward seeing you! Self-Help Connection is funded by the Office of Addictions and Mental Health to deliver health and wellness programs to Nova Scotians. We are unable to service participants residing outside Nova Scotia. We sincerely apologize for any inconvenience. We are
looking for ways to expand services.
1.First Name(Required.)
2.Last Name
3.Email Address(Required.)
4.Phone Number
5.City/Town(Required.)
6.How did you hear about this practice group?(Required.)
7.Have you attended our Therapeutic Touch® Practice Group before?(Required.)
8.If yes, how many times?(Required.)
9.Are you coming to give treatment, receive treatment, or both?(Required.)
10.Have you had a Therapeutic Touch® treatment before?(Required.)
11.If you are receiving a treatment, is it for a specific reason? If yes, please check off what reason.
12.Have you taken a workshop in Therapeutic Touch®?(Required.)
13.Are you 19 years of age or older?(Required.)
14.Do you currently reside inside Nova Scotia?(Required.)
15.I have read and agree to the Privacy Policy and Terms of Use.(Required.)