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Contact/Registration Form

Get in Touch

Please feel free to reach out with any questions, resources, or just to connect.  If you need more information, simply choose "Need Information" for all of the options on the form.  Thank you.

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*Registration is not complete until payment is received.  Payment instructions will be emailed after this form is submitted. Accepted methods: e-trasfer, PayPal, or invoice for support services.

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*Social Patients is an operated by The Patients Perspective.  Payments and receipts may display The Patients Perspective.

Select registration type
Select session time you are interested in
Payment method
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