Songbird Community Healing Center in Cotati desires to provide you with affordable health care and education for your mind, body, and spirit. Please let us know what most interests you by filling out our survey. Knowing our market will help us succeed. This will not add you to our mailing list unless you request it. Thank you so much!
Jasmine Gold, Director, Songbird Community Healing Service, www.songbirdcenter.org
1. Where do you live?
2. Are you willing to travel to Cotati for classes or events on any of the following (please rank all that interest you in order):
_Acupuncture _Astrology _Book/Poetry Readings and Signings _ Breathwork _Book Club (Specific Topics?__________) _Chiropractic Care _Conscious Communication _Conscious Parenting _Conscious Relationships _Dance/Movement _Dreamwork _Energy healing _Enneagram _Feng Shui _Herbalism _Homeopathy _Hypnotherapy _Kirtan/Chanting _Law of Attraction _Meditation _Naturopathy _Networking _Personal Development and Self Improvement _Qi Gong _Shamanism _Sound Healing _Tarot _Spirituality _Yoga _Other _______________________________
3. Preferred days and times:
_Weekday mornings _Weekday afternoons _Weekday evenings
_ Saturday mornings _Saturday afternoons _Saturday evenings
_Sunday mornings _Sunday afternoons _Sunday evenings
4. What are you preferred weekdays in order? _______________________________
5. What is the earliest time you can attend a class on a weekday evening? _______________________________
6. What is your preferred start time for a weekday evening? _______________________________
7. What is your preferred class length? _1 1/2 hours? _ 2 hours? _2 ½ h ours _3 hours _Half Day _All Day _Full Weekend
6. Which of the following do you like to attend _weekly classes _monthly classes _one time classes _other _______________________________
7. What are you usually willing to pay? _ $5/hour _$10/hour _$15/hour _$20/hour _$25/hour
8. Are you interested in a clinic appointment in any of the following areas? _Acupuncture Chiropractic _ Energy Healing _Herbalism-Western _Homeopathy _Naturopathy _Other ______________________________
9. How much are you willing to pay for a clinic appointment? _$5 _$10 _$15 _$20 _$25 _$30 _$35 _$40 _$45 _$50
10. Do you have services that you could trade Songbird for a class or clinic? If so, please specify _______________________________.
11. What sources do you look at to find out about events? ___________________________________
12. Are there any specific classes or teachers you would like us to offer (please provide contact information for teachers if you have it)? ________________________
13. Do you want to receive our monthly e-newsletter? ___________
14. Can we contact you for additional information? ___________
15. Have you heard of Songbird before this? _________________
16. Do you have any other suggestions? ______________________________________________________________________________________________________________________________________________________ ________________
Thank you so much for your time.