The Daring Way™/Rising Strong™ Questionnaire

Thank you for submitting the form below.  Please complete the * sections to provide the confidential information needed to complete your registration.  The rest of the questionnaire is optional, however, your willingness to complete it will help us know you better as you embark on this journey.  If you are registering as a couple, please have each person complete a questionnaire.  Your participation in the workshop/group will be confirmed upon the receipt of your payment along with the submission of The Daring Way™ Questionnaire and The Daring Way™ Consent Form found under the "MORE" tab.  These may be electronically submitted or mailed to us to:
​ Nancy Schornack, Second Journey Counseling, 6165 NW 86th St., Johnston, IA  50131.

    The Daring Way™ /Rising Strong™  Questionnaire

    Your guides for this workshops are Nancy Schornack, LMHC, CDWF-C and Dianne Morris Jones, LMHC-CDWF-C.   Nancy and Dianne have both completed an extensive training process with Dr. Brene’ Brown and her team to understand and teach this curriculum.  Your willingness to answer the questions below will help us best assess your readiness for a group experience such as this.  Thank you so much for your cooperation in answering these questions:
    Thank you so much for providing this information!  We will review the information you provided and follow up with you to confirm your registration.  
    Nancy and Dianne

    For questions or more information you may contact us at:
    daringindesmoines@gmail.com