• Empowering Wellness Initiative Registration Form: Company

    THANK YOU for registering your company for the Living Spirit Therapy Services Empowering Wellness Initiative! We understand that finances are incredibly tight and unpredictable for businesses at this time. We are hopefully that this will help improve support, morale, productivity, and overall health of your employees.
  • Company Contact Person

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  • How Does Your Team Register?

    Please ask anyone on your team who is interested in participating to register individually, selecting the box that says "my employer is covering the tab" under payment. This will allow us to collect their email addresses to share information and to find out what they have been doing or would like to do for self-care.
  • The link for team member registration is: https://hipaa.jotform.com/201406652142040

  • Payment

  • If you are paying by check you don't need to complete the bottom section of this form. Continue if you are paying by credit card.
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