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Account Information
First Name
Last Name
Organization Name
Email
Phone Number
You are a...
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Occupational Therapist
Speech and Language Pathologist
Psychologist
Neuropsychologist
Psychiatrist
Licensed Professional Counselor
Social Worker
Activity Director
Facilitator
Researcher
Student
Teacher
Doctor/Physician
Nurse
Physiotherapist / Physical therapist
Chiropractor
Retired
Patient
Parent/Spouse of a patient
Other
in ...
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Rehabilitation
Mental Health
Geriatrics
Education
How did you hear about us?
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Web Search
Social Media
Referral
Patient Request
Conference
Web Ad
I wish to receive offers and updates from HappyNeuron Pro.
Practice Information
How many therapists work in your practice?
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1 Therapist
2 to 3 Therapist
4 to 5 Therapist
6+ Therapists
How many patients receive cognitive training?
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less than 10
10 to 20
30 to 50
More than 50
What setting(s) do you work in? (Check all that apply)
Private Practice
Clinic
Hospital
University
School
Remote Therapy
Agecare Facility
Other
How do you conduct your treatment? (Check all that apply)
Inpatient
Outpatient
Virtual/Remote
Classroom
What is your field of specialization (Check all that apply)
Neurology (TBI, Stroke, AD, PD, MS, etc.)
Geriatrics (Aging, Dementia, etc.)
Mental Health (Schizophrenia, Depression, Addiction, etc.)
Learning Disabilities (ADHD, ASD, ID, etc.)
Other
Patient Age (Check all that apply)
Children (4-12)
Teens (13-18)
Adults (18+)
Elderly (65+)
Trial Information
Self service
7 days + Self training
Personal Training
30 days + Onboarding
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