Thank You For Your Interest

In The Confident Pleasure Program

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Confident Pleasure Interest Form

Last Name *

First Name *

Email *

Phone *

Describe the primary issue you would like to change if enrolled in the Confident Pleasure Program *

Which Good Groove programs are you interested in? (Select all that apply)

1:1 Coaching & Hypnosis with Dr. Janet

Good Groove Life Community Membership Program

5 Day Libido & Sensual Pleasure Activation Challenge

The Hot Flash Chill System

Doctor or Therapist's Name (If you were referred)

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Thank You For Your Interest

In The Confident Pleasure Program

Please complete the form below.

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