This questionnaire is confidential, and will only be seen by the organizer and the group facilitators. Please respond to all the following questions as fully as possible. Allow 5-10 minutes to answer all the questions. You need to complete the entire form, you cannot save your answers. Contact Sangeet at with any questions or issues.
You can also download and fill out a word document and send to Click here to download the word document.
The information requested below is very important. It will help the Group Facilitator(s) to work with you more effectively. The information will only be seen by the Group Facilitator(s) and the Group Organiser. You may continue on the back of this form if you need to.
Please read and then sign the following text: