Contribution Questionnaire

Name *

First

Last

What is your line of work? *

Tell us a little bit about your line of work.

What services would you like to provide to clients of Horizon Clear? *

These could be anything you think would be beneficial, even if they're outside your usual routine obligations.

How many hours per month are you wanting to dedicate to Horizon Clear? *

You don't have to be exact. Just a rough estimate would do.

Do you have a high-resolution headshot?

Yes
No
I'm not sure

If you agree, we'd like to present you on our site in a consistent manner across all specialists and therapists. If you don't have a professional headshot, and reside in the Cape Town area, we can provide a photographer

Horizon Clear

Hope and Healing

Contribution Questionnaire