Please take a few moments to fill out and submit this form.


First Name: Last Name:

Mailing Address:
Number and Street:
State: Zip:


E-Mail Address:

What are your interests in biofeedback?

Request the packet which best fits your health needs
if you are interested in an appoint:

Anxiety Stress and Phobias Hypertension
Chronic Pain Dental Pain
EEG/Brainwaves Headaches


Home /Psychotherapy & Counseling/What is Biofeedback? /Dental and Myofacial Pain/ Hypertension & Coronary Artery Disease / Chronic Pain & Headaches / Anxiety, Phobias & Panic Attacks / EEG, Brainwaves & Neurofeedback / Biofeedback Links /TMJ Photos /ADHA Article / Academic Performance / Attention Training / IM Links /Bill's Bio/ E-Mail/ Directions / Forms/ Testimonials