How Can I Be Most Helpful to You?

I am developing a complete series of video programs for the relief of unexplained pain, featuring Active Isolated Stretching, Somatic Movement and other methods.

By completing this brief survey you will help me to better understand your needs with respect to easy-to-follow pain relief routines that you can perform at home.

This Form cannot be submitted until the missing
fields (labelled below in red) have been filled in

What would like a video series about?

Please note that all fields followed by an asterisk must be filled in.

Please put a check next to the video series that would be most helpful to you.*

	A Series of Overall Daily Stretching Routines
	Stress Relief Techniques or Meditations
	Stretching Routines for Sciatica
	Stretching Routines for Hip Pain
	Stretching Routines for Neck Pain & Headaches
	Stretching Routines for Shoulder Pain

Would you add anything else to the list?

I experience persistent pain for which my doctor or health practitioner has provided no adequate explanation.

	Yes
	No

Of the primary roots of unexplained pain as outlined in my article, "Three Hidden Roots of Unexplained Pain," which do you believe is causing or worsening your pain:

	1. Postural Distortion and Muscular Compensation
	2. Constricted or Paradoxical Breathing
	3. The Grasping or Clinging Mind (Second Arrow Mind)
	Not sure or haven't read the article

The article, "Three Hidden Roots of Unexplained Pain" can be found under START HERE in the menu.

	Haven't read it yet
	Need to read it again
	Not interested in the roots of pain

First Name

E-Mail Address

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