Hoop Therapy Interest Form

Form Received

Thank You
For Reaching Out

I'll personally be in touch within 1–2 business days. I look forward to connecting and exploring whether Hoop Therapy is the right fit for you.

Personal Information

First Name *

Last Name *

Email Address *

Phone Number

About the Participant

Age *

Age Group *

Who is filling this out?

School Name

Areas of Interest

✓

Mindfulness & Focus

Staying present, managing emotions, improving attention

✓

Distress Tolerance

Coping with frustration, anxiety, and stress in healthy ways

✓

Emotion Regulation

Understanding and navigating emotions with intention

✓

Interpersonal Effectiveness

Communication, confidence, and building relationships

✓

General Resilience & Confidence

Building a stronger, more grounded sense of self

A Little More

What brings you here?

Best way to reach you *

Program Length

Best time to reach you

Your information is private and will never be shared.
Submitting this form does not create a therapeutic relationship.

Let's Connect& Get Started