Name *

First Name

Last Name

Please select the Fierce Love Consultation Group that most interests you *

The group will meet once a month on Tuesdays, from 12-2 pm (EST), starting in September.

A 5-month commitment for $700 ($140 per 2 hour session)

A 10-month commitment $1400 ($140 per 2 hour session)

Either option is fine

Please select whether you'd like to join as a Presenter or Learner. *

I want to show clinical video-tape as a Presenter (twice during the 10 month group, or once during the 5 month group).

I want to join as a Learner. I will be able to observe and participate but I won't be required to show clinical video-tape

Either option is fine