*EXAMPLES OF THE INFORMATION WE ASK THAT YOU PROVIDE* 

   HOW DID YOU HEAR ABOUT US?

• Our website? An internet search?
• Your church or other organization? Please provide the name of the church/organization and the name of the person who referred you. 
• Another Life Resources’ client, a friend, or a family member? Please provide their name and their relationship to you.
• A physician or therapist? Please provide their name and their relationship to you.