EmailMe Form - Pay It Forward Program

Your Name *

First Last

Use your first name and last intial unless you are receiving something by mail, then please use your full last name.

I would like *

Instant Duck Test PDF (download link sent to your email)

Two Duck Test cards by mail (I want to see if these will work for our group)

Your Email *

Address (not needed if you picked the download)

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Please make sure to include your zip. Unfortunately, at this time, we can only mail to the United States.

Stay in Touch (Our Three-Email Promise)

Email Notification of Future Recovery Tools & Gifts
(Optional)

Yes, keep me on the list for the 3 annual emails with notices for our promotions and free gifts.

Not yet. I want the gift, but let me check out the work first.

No emails, please. I’m just here for the one free tool.

I hate spam too. We send only 3 emails PER YEAR—practical tools, holiday gifts, and recovery exercises. Each one is designed to be useful, not noisy.

Note on your privacy: Because I value your consent, if you opted to receive our notices, you will receive a confirmation email from Mailchimp shortly. You must click the link in that email to confirm you actually want to hear from me. I manage this list personally and will never sell your info. Only 3 emails, no fluff stuff, and unsubscribe anytime with one click.