Therapists Survey - Insight Psychological Group, Westfield, Maywood, Springfield, Little Falls, New Jersey

Here-and-Now Group Workshop Survey

Please use this survey to indicate your interest and availability to attend Jacob Winkler's exclusive IPG therapist workshops.

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Therapist's Name

First

Last

Therapist's Email

During which morning group did you hear Jacob's presentation?

1) I intend to participate in Jacob’s workshop and look forward to it!

2) Please indicate your preference for timing below

	Preferred	Less preferred, but I can make it work	Not going to work for me
Wednesdays, 1pm-3pm: Sept 13, 20 and 27	PreferredWednesdays, 1pm-3pm: Sept 13, 20 and 27 Preferred	Less preferred, but I can make it workWednesdays, 1pm-3pm: Sept 13, 20 and 27 Less preferred, but I can make it work	Not going to work for meWednesdays, 1pm-3pm: Sept 13, 20 and 27 Not going to work for me
Thursdays, 1pm-3pm: Sept 14, 21, and 2	PreferredThursdays, 1pm-3pm: Sept 14, 21, and 2 Preferred	Less preferred, but I can make it workThursdays, 1pm-3pm: Sept 14, 21, and 2 Less preferred, but I can make it work	Not going to work for meThursdays, 1pm-3pm: Sept 14, 21, and 2 Not going to work for me

I intend to obtain CE credits from the workshop