Hi client ,
I'm excited to learn more about you and to tell you more about the group you are interested in. If you are undecided we will discuss the options.
Birthday {"type":"text","name":"age","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":"Month/Day/Year"}
Group Interest
Young Adulting with ADHD ( ages 18- 24) Intro Group: Foundations for Adulting with ADHD Mastering Adulting with ADHD (some previous ADHD support recommended) Momentum (Accountability Group, Monthly Membership) Building Healthy Habits & Life Balance Speciality Group Professionals (Accountability Group) Mastermind Group for Aspiring Entrepreneurs/Self Employed I need help deciding {"type":"checkbox","name":"__generic","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please make a selection for this item.","options":"Young Adulting with ADHD ( ages 18- 24)\nIntro Group: Foundations for Adulting with ADHD\nMastering Adulting with ADHD (some previous ADHD support recommended) \nMomentum (Accountability Group, Monthly Membership)\nBuilding Healthy Habits & Life Balance Speciality Group\nProfessionals (Accountability Group)\nMastermind Group for Aspiring Entrepreneurs/Self Employed\nI need help deciding"}
What are the biggest challenges and what is prompting you to do take action to address this challenge right NOW? {"type":"textarea","name":"strugglingWith","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":"A few words or lots of details will do! Up to you. Nothing formal! I'm the only one who sees your answer."}
Have you had any previous/current ADHD focused therapy/coaching to help with your challenges?
{"type":"textarea","name":"__generic3","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":"A few words or sentences will do! Up to you."}
Is there anything else you want us to know?
{"type":"textarea","name":"__generic4","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
- Thanks for the information! Good job in taking this 1st step! 
During this free phone consult, you can tell us more about your situation and we can tell you about the different types of groups and workshops we offer throughout the year.