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Bloom With Michelle

Please take a moment to fill out the survey to join Bloom with Michelle. Once you've completed the survey, you will receive an email or phone call from Michelle within 48 hours. 

Click the button below to start.

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Question 1 of 11

What is your first and last name?

Question 2 of 11

What is your email address and phone number?

 

Question 3 of 11

Does your child have a diagnosis? If yes, can you share the diagnosis with us?

Question 4 of 11

Would you say that your child has a difficult or sensitive personality type? 

Question 5 of 11

Do you consider yourself a sensitive parent? 

Question 6 of 11

Why do you want to join Bloom with Michelle? 

Question 7 of 11

What are you hoping to achieve from Bloom? 

Question 8 of 11

Are you committed to implementing the suggestions and collecting data? 

Question 9 of 11

 What have you tried so far to support your parenting journey? 

Question 10 of 11

How much time do you have each week to learn new skills and implement them? 

Question 11 of 11

Is there anything else you'd like to share with Michelle?

Confirm and Submit