First Name*
Last Name*
Your Age*
Email*
Phone*
Have you in the past or currently seen a counsellor at Alpine Counselling Clinic? YES/NO
Are you currently employed? YES/NO
Reasons, Hopes, Expectations for taking this series?
Request a call back if you need more information about the series.
YESNo
Please be aware that the forest trails have somewhat uneven ground due to rocks or protruding roots occasionally on the paths. It is the responsibility of each participant to ensure proper footwear to minimize the risks of falling, as we can not be held responsible for an injury that could result from a fall. Type agree below.*