Form for Emotional Category

You may enter your contribution to the Emotional Health category with the simple form below. I will send you a coupon good for a Hug in return. Thank you for participating!
1) My name is ............................................
(Do not hit return)
2) I live in (city and/or state and/or country).......
(Do not hit return)
3) My Email address is (needed to send Hug certificate)
(Do not hit return)

4) How often do you visit this Holistic Health page?

----Almost Daily

-Once per week

Once per month

--Once per year

5) Please write your contribution to this subject:

6) Do you have a question? I will research where we can find an answer. Or do you have a suggestion to improve this site?

7) How much do you like the idea of an interactive site?

If you wish to make changes to an entry, please hit CLEAR first, or the form will not record them. Thank you.

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