For selected participants only. Use the participant code given in your selection email (for example, RR-001). Do not put your name, email, or phone number on this form — those are already held in our basic contact system, and this detail form is linked by code only.
Participation is voluntary. You can skip any question, stop filming at any time, or withdraw by contacting Dixon@reflectionrecovery.org. This is not medical care, therapy, counselling, or a clinical study. Separate written agreements/releases will be required before filming. This form alone does not give permission to film or publish you.
Do not share a diagnosis, treatment history, detailed drug-use history, trauma details, or a days-sober count on this form. The optional substance-type question above is broad category only, for diverse group creation.
Payment: one-on-one $100 total, paid after completion of both sessions; group $250 per participant, paid after completion of the session. ePub copy delivered on confirmation of your appointment. All sessions scheduled as funding permits.
Participants by age demographic, ideally 10 per demographic. If your age is unknown / Not Qualified, you cannot be assigned to a demographic group — panel assignment is confirmed after selection, never guessed.