TRAUMATIC INCIDENT REDUCTION (TIR)

TIR ENQUIRY FORM

You may use this TIR Enquiry Form to:

Solicit a personal response regarding a question you have about Traumatic Incident Reduction (TIR)
Request enrollment and/or additional information about TIR Training Workshops
Contact a trained Traumatic Incident Reduction (TIR) facilitator (therapist) in your area
Request additional materials about TIR, trauma and PTSD
Request Membership in the Traumatic Incident Reduction Association (TIRA)
Additional Note: New Training Workshops and Certified TIR Facilitators are being updated on an ongoing basis. This website may not always reflect the most current updates, so please don't hesitate to contact us if you don't see a training workshop or a certified faciliator in your area. We'll be glad to provide you with the most current information upon your request!

Please fill out as much information in the fields below as possible. All information will be held in strictest confidence and your name will not be used for any purpose other than our responding to you in the manner that you request. This form can be submitted to us automatically from your web browser by clicking on the Submit button at the end of the form.

For questions, suggestions, comments or technical problems with this form, rather than the content therein,
please contact the webmaster of The Healing Center On-Line.

Let Us Know How to Contact You:
First Name:
Last Name:
Title:	Other:
Organization (if applicable):
Occupation:	Other:
Street:
City:
State or Province:	Other:
Zip or Postal Code:
Country:
E-Mail Address:
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Telephone:
Fax:
I prefer to be contacted by:	Other:
Let Us Know What You Need:
In what field do you operate?:	Other:
Regarding TIR, in what areas are you interested?:	Other:
Are you currently using TIR in your practice as a therapist, counsellor or helper?	Yes No
Would you like to use TIR in your practice as a therapist, counsellor or helper?	Yes No Possibly
Would you like to enroll in a TIR Training Workshop?:	Yes No Possibly
If you answered "yes" to the above question, please let us know the location and date of the workshop you wish to attend ( see calendar ):	Location: Date:
If there is not a workshop scheduled for your area, would you be interested in bringing a certified TIR trainer to your venue to conduct a training?	Yes No Possibly
Would you like a certified TIR facilitator near your area to contact you about working with you - or with someone you know - to resolve personal trauma-related issues?	Yes No Possibly
If you answered "yes" or "possibly" to the above question, please let us know the city and state or country in which you need this service:	City: State or Country:
If there is not a certified TIR facilitator in your area, would you will be willing to travel to the closest practitioner to receive his/her services? (See our list of Certified Practitioners)	Yes No Possibly
Would you like to become a member of the Traumatic Incident Reduction Association (TIRA)? (See the benefits of TIRA membership)	Yes No Already a Member
Give Us Feedback to Help Us Improve Our Services to You
How did you find this website?	Other:
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