Registration Form

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* 1. Email address

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* 2. First name

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* 3. Last name

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* 4. City/town

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* 5. State

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* 6. Zip

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* 7. Are you currently taking psychiatric medication?

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* 8. What current med(s) are you planning to withdraw from or are already in the process of withdrawing from?

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* 9. For how long have you been taking psychiatric medications?

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* 10. Have you tried in the past to come off psychiatric medications?

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* 11. Are you able to commit to attending all ten workshop gatherings?

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* 12. How did you hear about this workshop?

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