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Perceptual Healing Journey Across America Questionnaire


I want to know what your perception is of your world.
Please fill out and submit this online survey if you would like to be heard.

_____________________________

How often do you laugh?





Are you:
Religious... attend a church regularly
and/or
Spiritual... practice meditation, kindness, yoga etc



How often are you hugged?





How often do you initiate hugs?





Do you meditate?





Do you exercise?





Do you consider yourself a healthy person?




Do you consider yourself a loving person?




Have you healed from a serious illness in your life?




Are you interested in being part of the Perceptual Healing Journey Research and documentary ?





Would you like us to let you know when we are coming to your area?




Are you interested in having us speak to your group or business?




Your name
Your email address
Your phone number
Your home address