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1.
Enrollment Form
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First Name
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This service was recommended by:
Your Age Group
18-25 years old
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34-41 years old
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Describe your challenge recently.
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What do you think are the factors affecting it?
How is it affecting your daily performance and productivity?
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How do you usually manage these difficulties?
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What kind of support do you need?
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What specific topic would you like to focus on?
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What are you preferred supplemental resources
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Requested number of sessions
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