Success Story - created by phpFormGenerator

InnerPowerment Success Story

How has InnerPowerment helped you? Share your success story with Dr. M.

First Name
Last Name
Occupation or Title
Company/Organization
(if this success story involves your organization)
Industry
Location (City, State/Province)
Country
Month, Year your success story occurred
Abstract: Please give a 1 or 2-sentence summary of your success story
The Challenge: Please describe the challenge you were having before you achieved success.
The Solution: Please list the specific InnerPowerment workshops, techniques etc. you used to approach your situation.
The Approach: Please describe why and how you selected your solutions, and described how you used them approach your situation.
Results: What was the outome of using the above solutions and approach?
Additonal Comment: Please add any additional comments, quotes, testimonials or other information you would like to include.
Confidentiality - Personal and company names are kept confidential unless otherwised indicated below. Success stories may be shared on the InnerPowerment website, in the newsletter or other materials, or they may be used for study and training purposes. Dr. M will use a fictitious name to protect confidentiality unless you select one or more of the options below. Journalists who visit the web site or subscribe to the newsletter may express interest in reprinting a success story or interviewing people named in the stories.
Use my real, full name in my story Use my first name and last initial in my story Use my first name only or my initials onlyKeep my name confidential but contact me if there is media interest in my story Allow the media to contact me directly for an interview
E-mail Address
Telephone
Alternate Telephone

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