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Characteristic Symptoms

Anxiety is a normal cognitive and physiological response designed to call our attention to the seriousness of an event or situation and motivate us to action. Anxiety disorders are not mild and brief, but severe and chronic. Panic attacks, a consuming wave of fear and dread, are a common characteristic of the anxiety disorders.

A panic attack is a sudden surge of overwhelming fear and anxiety that reaches a peak within minutes. The DSM-5 lists 13 potential symptoms of a panic attack:

  • Increased heart rate
  • Sweating
  • Trembling
  • Shortness of breath
  • Feelings of choking
  • Chest pain
  • Nausea
  • Dizziness
  • Chills or heat sensations
  • Numbness or tingling
  • Feelings of unreality or depersonalization
  • Fear of losing control
  • Fear of dying

Four or more of these symptoms must be present for the episode to be considered a panic attack. A panic attack may be a one-time occurrence in an individual’s life, but many people experience multiple episodes.

Types of Anxiety Disorders

SEPARATION ANXIETY DISORDER

Separation Anxiety Disorder is an inappropriate and excessive fear or anxiety concerning separation from home or those to whom the individual is attached. The fear or anxiety is persistent, lasting at least four weeks in children and adolescents and six months or more in adults.

SELECTIVE MUTISM

Selective Mutism is a failure to speak in some social settings and to some people for at least one month. A child with selective mutism may talk normally at home, or when alone with their parents, but cannot speak at all, or speak above a whisper, in other social settings.

Some people’s lives become restricted to the point that they avoid everyday activities...
SPECIFIC PHOBIA

Specific Phobia is extreme and irrational fear or anxiety about a specific object or situation. Specific phobias commonly focus on animals, insects, germs, heights, thunder, driving, public transportation, flying, dental or medical procedures, and elevators.

SOCIAL ANXIETY DISORDER

Social Anxiety Disorder is marked fear or anxiety about social situations in which the individual is exposed to possible scrutiny or judgment by others. The fear or anxiety causes clinically significant distress, lasting for six months or more.

PANIC DISORDER

Panic Disorder is recurrent panic attacks striking suddenly and without warning. Persons with panic disorder often develop intense anxiety between episodes, worrying about when and where the next panic attack will occur. Some people’s lives become restricted to the point that they avoid even everyday activities such as driving or going to the store.

AGORAPHOBIA

Agoraphobia is characterized by the avoidance of situations or places in which it is thought that escape might be difficult, or help unavailable in the event of a panic attack or other incapacitating or embarrassing symptoms.

GENERALIZED ANXIETY DISORDER (GAD)

Generalized Anxiety Disorder (GAD) is excessive anxiety and worry, even though there is little or nothing to provoke it. The anxiety is severe enough to affect the individual’s ability to function in their daily lives. The person will often recognize that their anxiety is more intense than the situation warrants, however, they may have difficulty in controlling these thoughts and feelings. With GAD, the anxiety is usually accompanied by physical symptoms such as fatigue, sleeplessness, headache, muscle tension, sweating, shortness of breath, irritability, and hot flashes.

Prevalence and Age of Onset

Anxiety disorders are the most common mental illness in the United States, affecting approximately 40 million adults (18% of the population). Women are twice as likely to be diagnosed with an anxiety disorder as men. The age of onset of selective mutism is usually before 5 years while separation anxiety disorder, specific phobia, and social anxiety disorder usually first manifest in later childhood. The common age of onset for panic disorder and agoraphobia is early adulthood while generalized anxiety disorder has the latest onset of the anxiety disorders, around 30 years. Individuals with anxiety disorders are at high risk for coexisting conditions, such as depression and substance abuse.

Treatment & Support

ANXIOLYTICS

Anxiolytic (anxiety-relieving) drugs are available for health professionals to prescribe. The most common side effect of these drugs is daytime drowsiness, or what some have described as a “hung-over feeling.” Benzodiazepines lower anxiety by increasing the activity of the neurotransmitter GABA. Due to risk of dependency, individuals with substance-abuse problems are not good candidates for treatment with benzodiazepines.

Buspirone (BuSpar) is a unique anxiolytic agent found it to be effective in treating generalized anxiety disorder. While the exact mechanism of action for buspirone is unknown, its anti-anxiety effects are the result of changes produced in the serotonin neurotransmitter system. Common side effects include dizziness, drowsiness, and nausea. Unlike the benzodiazepines, buspirone is not addictive and must be taken for at least two weeks to counteract the symptoms of anxiety.

ANTIDEPRESSANTS

Due to the addictive risks associated with benzodiazepines, antidepressant medications—particularly selective serotonin reuptake inhibitors (SSRIs)—are increasingly being used as the initial treatment for anxiety disorders. Examples of SSRIs include Prozac, Zoloft, Paxil, and Celexa.

As mentioned previously, these drugs work specifically to increase levels of serotonin in the brain. Older medications such as tricyclic antidepressants (e.g., Anafranil) and monoamine oxidase inhibitors (e.g., Nardil) that affect a wider range of neurotransmitters are also prescribed for anxiety disorders. These medications have been shown to be as effective as the SSRIs in treating anxiety disorders, but because the side effects of these medications can be severe, most physicians and patients prefer the SSRIs.

PSYCHOTHERAPY

The psychotherapeutic approach shown to be most effective in treating anxiety disorders is cognitive-behavioral therapy (CBT). CBT reduces anxiety by eliminating beliefs and behaviors that maintain the disorder. To be effective, the therapy must be specific to the individual’s anxieties. For example, an individual with a specific phobia who is fearful of dirt and germs may be encouraged to actually get his or her hands dirty during a session. As anxiety builds because of the “contamination,” the therapist works with the patient to develop skills for managing the physical sensations and negative thoughts. Over a number of sessions, the therapist might encourage the person to wait for increasingly longer periods of time before washing. Treatment usually lasts from twelve to twenty weeks.

A Spiritual Perspective

The anxiety disorders are brain disorders! The overwhelming panic described by David in Psalm 55 is not the same as the normal levels of worry and concern that Jesus talks about in the Sermon on the Mount (Matthew 6:25–34) and the apostles Paul (Philippians 4:6) and Peter (1 Peter 5:7) mention in their epistles. As the Body of Christ we must be aware that the great truth the Bible does teach us about anxiety is that when we do struggle, God is present (Psalm 94:19), taking care of our needs and providing the sustaining grace needed to persevere in a fallen world.

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</div></li><li id="field_1_17" class="gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_17"><label class='gfield_label gfield_label_before_complex' >Work Address<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label> <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address' id='input_1_17' > <span class='ginput_full address_line_1 ginput_address_line_1' id='input_1_17_1_container' > <input type='text' name='input_17.1' id='input_1_17_1' value='' aria-required='true' /> <label for='input_1_17_1' id='input_1_17_1_label' >Street Address</label> </span><span class='ginput_full address_line_2 ginput_address_line_2' id='input_1_17_2_container' > <input type='text' name='input_17.2' id='input_1_17_2' value='' aria-required='false' /> <label for='input_1_17_2' id='input_1_17_2_label' >Address Line 2</label> </span><span class='ginput_left address_city ginput_address_city' id='input_1_17_3_container' > <input type='text' name='input_17.3' id='input_1_17_3' value='' aria-required='true' /> <label for='input_1_17_3' id='input_1_17_3_label' >City</label> </span><span class='ginput_right address_state ginput_address_state' id='input_1_17_4_container' > <input type='text' name='input_17.4' id='input_1_17_4' value='' aria-required='true' /> <label for='input_1_17_4' id='input_1_17_4_label' >State / Province / Region</label> </span><span class='ginput_left address_zip ginput_address_zip' id='input_1_17_5_container' > <input type='text' name='input_17.5' id='input_1_17_5' value='' aria-required='true' /> <label for='input_1_17_5' id='input_1_17_5_label' >ZIP / Postal Code</label> </span><span class='ginput_right address_country ginput_address_country' id='input_1_17_6_container' > <select name='input_17.6' id='input_1_17_6' aria-required='true' ><option value='' ></option><option value='Afghanistan' >Afghanistan</option><option value='Albania' >Albania</option><option value='Algeria' >Algeria</option><option value='American Samoa' >American Samoa</option><option value='Andorra' >Andorra</option><option value='Angola' >Angola</option><option value='Anguilla' >Anguilla</option><option value='Antarctica' >Antarctica</option><option value='Antigua and Barbuda' >Antigua and Barbuda</option><option value='Argentina' >Argentina</option><option value='Armenia' >Armenia</option><option value='Aruba' >Aruba</option><option value='Australia' >Australia</option><option value='Austria' >Austria</option><option value='Azerbaijan' >Azerbaijan</option><option value='Bahamas' >Bahamas</option><option value='Bahrain' >Bahrain</option><option value='Bangladesh' >Bangladesh</option><option value='Barbados' >Barbados</option><option value='Belarus' >Belarus</option><option value='Belgium' >Belgium</option><option value='Belize' >Belize</option><option value='Benin' >Benin</option><option value='Bermuda' >Bermuda</option><option value='Bhutan' >Bhutan</option><option value='Bolivia' >Bolivia</option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba</option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina</option><option value='Botswana' >Botswana</option><option value='Bouvet Island' >Bouvet Island</option><option value='Brazil' >Brazil</option><option value='British Indian Ocean Territory' >British Indian Ocean Territory</option><option value='Brunei Darussalam' >Brunei Darussalam</option><option value='Bulgaria' >Bulgaria</option><option value='Burkina Faso' >Burkina Faso</option><option value='Burundi' >Burundi</option><option value='Cabo Verde' >Cabo Verde</option><option value='Cambodia' >Cambodia</option><option value='Cameroon' >Cameroon</option><option value='Canada' >Canada</option><option value='Cayman Islands' >Cayman Islands</option><option value='Central African Republic' >Central African Republic</option><option value='Chad' >Chad</option><option value='Chile' >Chile</option><option value='China' >China</option><option value='Christmas Island' >Christmas Island</option><option value='Cocos Islands' >Cocos Islands</option><option value='Colombia' >Colombia</option><option value='Comoros' >Comoros</option><option value='Congo' >Congo</option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the</option><option value='Cook Islands' >Cook Islands</option><option value='Costa Rica' >Costa Rica</option><option value='Croatia' >Croatia</option><option value='Cuba' >Cuba</option><option value='Curaçao' >Curaçao</option><option value='Cyprus' >Cyprus</option><option value='Czechia' >Czechia</option><option value='Côte d&#039;Ivoire' >Côte d&#039;Ivoire</option><option value='Denmark' >Denmark</option><option value='Djibouti' >Djibouti</option><option value='Dominica' >Dominica</option><option value='Dominican Republic' >Dominican Republic</option><option value='Ecuador' >Ecuador</option><option value='Egypt' >Egypt</option><option value='El Salvador' >El Salvador</option><option value='Equatorial Guinea' >Equatorial Guinea</option><option value='Eritrea' >Eritrea</option><option value='Estonia' >Estonia</option><option value='Eswatini' >Eswatini</option><option value='Ethiopia' >Ethiopia</option><option value='Falkland Islands' >Falkland Islands</option><option value='Faroe Islands' >Faroe Islands</option><option value='Fiji' >Fiji</option><option value='Finland' >Finland</option><option value='France' >France</option><option value='French Guiana' >French Guiana</option><option value='French Polynesia' >French Polynesia</option><option value='French Southern Territories' >French Southern Territories</option><option value='Gabon' >Gabon</option><option value='Gambia' >Gambia</option><option value='Georgia' >Georgia</option><option value='Germany' >Germany</option><option value='Ghana' >Ghana</option><option value='Gibraltar' >Gibraltar</option><option value='Greece' >Greece</option><option value='Greenland' >Greenland</option><option value='Grenada' >Grenada</option><option value='Guadeloupe' >Guadeloupe</option><option value='Guam' >Guam</option><option value='Guatemala' >Guatemala</option><option value='Guernsey' >Guernsey</option><option value='Guinea' >Guinea</option><option value='Guinea-Bissau' >Guinea-Bissau</option><option value='Guyana' >Guyana</option><option value='Haiti' >Haiti</option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands</option><option value='Holy See' >Holy See</option><option value='Honduras' >Honduras</option><option value='Hong Kong' >Hong Kong</option><option value='Hungary' >Hungary</option><option value='Iceland' >Iceland</option><option value='India' >India</option><option value='Indonesia' >Indonesia</option><option value='Iran' >Iran</option><option value='Iraq' >Iraq</option><option value='Ireland' >Ireland</option><option value='Isle of Man' >Isle of Man</option><option value='Israel' >Israel</option><option value='Italy' >Italy</option><option value='Jamaica' >Jamaica</option><option value='Japan' >Japan</option><option value='Jersey' >Jersey</option><option value='Jordan' >Jordan</option><option value='Kazakhstan' >Kazakhstan</option><option value='Kenya' >Kenya</option><option value='Kiribati' >Kiribati</option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of</option><option value='Korea, Republic of' >Korea, Republic of</option><option value='Kuwait' >Kuwait</option><option value='Kyrgyzstan' >Kyrgyzstan</option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic</option><option value='Latvia' >Latvia</option><option value='Lebanon' >Lebanon</option><option value='Lesotho' >Lesotho</option><option value='Liberia' >Liberia</option><option value='Libya' >Libya</option><option value='Liechtenstein' >Liechtenstein</option><option value='Lithuania' >Lithuania</option><option value='Luxembourg' >Luxembourg</option><option value='Macao' >Macao</option><option value='Madagascar' >Madagascar</option><option value='Malawi' >Malawi</option><option value='Malaysia' >Malaysia</option><option value='Maldives' >Maldives</option><option value='Mali' >Mali</option><option value='Malta' >Malta</option><option value='Marshall Islands' >Marshall Islands</option><option value='Martinique' >Martinique</option><option value='Mauritania' >Mauritania</option><option value='Mauritius' >Mauritius</option><option value='Mayotte' >Mayotte</option><option value='Mexico' >Mexico</option><option value='Micronesia' >Micronesia</option><option value='Moldova' >Moldova</option><option value='Monaco' >Monaco</option><option value='Mongolia' >Mongolia</option><option value='Montenegro' >Montenegro</option><option value='Montserrat' >Montserrat</option><option value='Morocco' >Morocco</option><option value='Mozambique' >Mozambique</option><option value='Myanmar' >Myanmar</option><option value='Namibia' >Namibia</option><option value='Nauru' >Nauru</option><option value='Nepal' >Nepal</option><option value='Netherlands' >Netherlands</option><option value='New Caledonia' >New Caledonia</option><option value='New Zealand' >New Zealand</option><option value='Nicaragua' >Nicaragua</option><option value='Niger' >Niger</option><option value='Nigeria' >Nigeria</option><option value='Niue' >Niue</option><option value='Norfolk Island' >Norfolk Island</option><option value='North Macedonia' >North Macedonia</option><option value='Northern Mariana Islands' >Northern Mariana Islands</option><option value='Norway' >Norway</option><option value='Oman' >Oman</option><option value='Pakistan' >Pakistan</option><option value='Palau' >Palau</option><option value='Palestine, State of' >Palestine, State of</option><option value='Panama' >Panama</option><option value='Papua New Guinea' >Papua New Guinea</option><option value='Paraguay' >Paraguay</option><option value='Peru' >Peru</option><option value='Philippines' >Philippines</option><option value='Pitcairn' >Pitcairn</option><option value='Poland' >Poland</option><option value='Portugal' >Portugal</option><option value='Puerto Rico' >Puerto Rico</option><option value='Qatar' >Qatar</option><option value='Romania' >Romania</option><option value='Russian Federation' >Russian Federation</option><option value='Rwanda' >Rwanda</option><option value='Réunion' >Réunion</option><option value='Saint Barthélemy' >Saint Barthélemy</option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha</option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis</option><option value='Saint Lucia' >Saint Lucia</option><option value='Saint Martin' >Saint Martin</option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon</option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines</option><option value='Samoa' >Samoa</option><option value='San Marino' >San Marino</option><option value='Sao Tome and Principe' >Sao Tome and Principe</option><option value='Saudi Arabia' >Saudi Arabia</option><option value='Senegal' >Senegal</option><option value='Serbia' >Serbia</option><option value='Seychelles' >Seychelles</option><option value='Sierra Leone' >Sierra Leone</option><option value='Singapore' >Singapore</option><option value='Sint Maarten' >Sint Maarten</option><option value='Slovakia' >Slovakia</option><option value='Slovenia' >Slovenia</option><option value='Solomon Islands' >Solomon Islands</option><option value='Somalia' >Somalia</option><option value='South Africa' >South Africa</option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands</option><option value='South Sudan' >South Sudan</option><option value='Spain' >Spain</option><option value='Sri Lanka' >Sri Lanka</option><option value='Sudan' >Sudan</option><option value='Suriname' >Suriname</option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen</option><option value='Sweden' >Sweden</option><option value='Switzerland' >Switzerland</option><option value='Syria Arab Republic' >Syria Arab Republic</option><option value='Taiwan' >Taiwan</option><option value='Tajikistan' >Tajikistan</option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of</option><option value='Thailand' >Thailand</option><option value='Timor-Leste' >Timor-Leste</option><option value='Togo' >Togo</option><option value='Tokelau' >Tokelau</option><option value='Tonga' >Tonga</option><option value='Trinidad and Tobago' >Trinidad and Tobago</option><option value='Tunisia' >Tunisia</option><option value='Turkmenistan' >Turkmenistan</option><option value='Turks and Caicos Islands' >Turks and Caicos Islands</option><option value='Tuvalu' >Tuvalu</option><option value='Türkiye' >Türkiye</option><option value='US Minor Outlying Islands' >US Minor Outlying Islands</option><option value='Uganda' >Uganda</option><option value='Ukraine' >Ukraine</option><option value='United Arab Emirates' >United Arab Emirates</option><option value='United Kingdom' >United Kingdom</option><option value='United States' selected='selected'>United States</option><option value='Uruguay' >Uruguay</option><option value='Uzbekistan' >Uzbekistan</option><option value='Vanuatu' >Vanuatu</option><option value='Venezuela' >Venezuela</option><option value='Viet Nam' >Viet Nam</option><option value='Virgin Islands, British' >Virgin Islands, British</option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.</option><option value='Wallis and Futuna' >Wallis and Futuna</option><option value='Western Sahara' >Western Sahara</option><option value='Yemen' >Yemen</option><option value='Zambia' >Zambia</option><option value='Zimbabwe' >Zimbabwe</option><option value='Åland Islands' >Åland Islands</option></select> <label for='input_1_17_6' id='input_1_17_6_label' >Country</label> </span> <div class='gf_clear gf_clear_complex'></div> </div></li><li id="field_1_20" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_20"><h2 class="gsection_title"></h2></li><li id="field_1_14" class="gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_14"><label class='gfield_label gfield_label_before_complex' >Are you of Hispanic/Latino/Spanish origin?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_1_14'><li class='gchoice gchoice_1_14_1'> <input class='gfield-choice-input' 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<input class='gfield-choice-input' name='input_15.2' type='checkbox' value='Asian' id='choice_1_15_2' /> <label for='choice_1_15_2' id='label_1_15_2'>Asian</label> </li><li class='gchoice gchoice_1_15_3'> <input class='gfield-choice-input' name='input_15.3' type='checkbox' value='Black or African American' id='choice_1_15_3' /> <label for='choice_1_15_3' id='label_1_15_3'>Black or African American</label> </li><li class='gchoice gchoice_1_15_4'> <input class='gfield-choice-input' name='input_15.4' type='checkbox' value='Native Hawaiian or Other Pacific Islander' id='choice_1_15_4' /> <label for='choice_1_15_4' id='label_1_15_4'>Native Hawaiian or Other Pacific Islander</label> </li><li class='gchoice gchoice_1_15_5'> <input class='gfield-choice-input' name='input_15.5' type='checkbox' value='White' id='choice_1_15_5' /> <label for='choice_1_15_5' id='label_1_15_5'>White</label> </li><li class='gchoice gchoice_1_15_6'> <input class='gfield-choice-input' name='input_15.6' type='checkbox' value='Other' id='choice_1_15_6' /> <label for='choice_1_15_6' id='label_1_15_6'>Other</label> </li></ul></div></li><li id="field_1_21" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_21"><h2 class="gsection_title"></h2></li><li id="field_1_18" class="gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_18"><label class='gfield_label gfield_label_before_complex' >Terms &amp; Conditions<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_consent'><input name='input_18.1' id='input_1_18_1' type='checkbox' value='1' aria-describedby="gfield_consent_description_1_18 gfield_description_1_18" aria-required="true" aria-invalid="false" /> <label class="gfield_consent_label" for='input_1_18_1' >I understand and acknowledge that by 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All copyrights, trademarks, content, business methods, graphics, designs and documents posted on this website, as well as the look and feel of this website ("Intellectual Property") are the property of the Hope and Healing Center & Institute.<br /> <br /> The user may download one copy of the materials on any single computer and print a copy of the materials solely for use in learning about or utilizing Gateway to Hope's training materials and resources. The user may not otherwise copy, print, reproduce, distribute, transmit, upload, download, store, use, or change the materials. All such materials are copyrighted by the Hope and Healing Center & Institute.</div></li><li id="field_1_13" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_13"><h2 class="gsection_title"></h2></li><li id="field_1_9" class="gfield field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_1_9"><label class='gfield_label gfield_label_before_complex' >Newsletter Optin</label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_1_9'><li class='gchoice gchoice_1_9_1'> <input class='gfield-choice-input' name='input_9.1' type='checkbox' value='Please sign me up for updates, insights, resources, and more.' checked='checked' id='choice_1_9_1' /> <label for='choice_1_9_1' id='label_1_9_1'>Please sign me up for updates, insights, resources, and more.</label> </li></ul></div></li><li id="field_1_22" class="gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_22"><label class='gfield_label' for='input_1_22' >Phone</label><div class='ginput_container'><input name='input_22' id='input_1_22' type='text' value='' autocomplete='new-password'/></div><div class='gfield_description' id='gfield_description_1_22'>This field is for validation purposes and should be left unchanged.</div></li></ul></div> <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_1' class='gform_button button' value='Submit' onclick='if(window["gf_submitting_1"]){return false;} if( !jQuery("#gform_1")[0].checkValidity || jQuery("#gform_1")[0].checkValidity()){window["gf_submitting_1"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_1"]){return false;} if( !jQuery("#gform_1")[0].checkValidity || jQuery("#gform_1")[0].checkValidity()){window["gf_submitting_1"]=true;} jQuery("#gform_1").trigger("submit",[true]); }' /> <input type='hidden' class='gform_hidden' name='is_submit_1' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='1' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_1' value='WyJ7XCIxOC4xXCI6XCI4ZWVjNjNkZDZhMDFjYjE5MjEyMzliY2M5YWNkNmNlMVwiLFwiMTguMlwiOlwiOTA2YWZlM2IyN2U5ZDFjYTQ4NmFkOGM4YmE3YWZlMzlcIixcIjE4LjNcIjpcImY4MGQwNTNlMzUwZjU5ZDM3M2M2YzJlZTc5ODViMzY2XCJ9IiwiZjI0MDg4NjhmY2IxNWYxMTZhN2QxYmJjNTk4YzAwNWYiXQ==' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_1' id='gform_target_page_number_1' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_1' id='gform_source_page_number_1' value='1' /> <input type='hidden' name='gform_field_values' value='' /> </div> <input type="hidden" id="ct_checkjs_28f0b864598a1291557bed248a998d4e" name="ct_checkjs" value="0" /><script type="text/javascript" >setTimeout(function(){var ct_input_name = "ct_checkjs_28f0b864598a1291557bed248a998d4e";if (document.getElementById(ct_input_name) !== null) {var ct_input_value = document.getElementById(ct_input_name).value;document.getElementById(ct_input_name).value = document.getElementById(ct_input_name).value.replace(ct_input_value, 'daff13625f026def51775140059231ba46d5adca1056f439641605167e8402c2');}}, 1000);</script></form> </div>
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[gravityforms id=1]
<div class='gf_browser_unknown gform_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_1' > <div class='gform_heading'> <h3 class="gform_title">EMPOWER Online Training Registration</h3> <span class='gform_description'></span> </div><form method='post' enctype='multipart/form-data' id='gform_1' action='/anxiety-disorders/' novalidate> <div class='gform_body gform-body'><ul id='gform_fields_1' class='gform_fields top_label form_sublabel_below description_below'><li id="field_1_1" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_1"><label class='gfield_label gfield_label_before_complex' >Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_1_1'> <span id='input_1_1_3_container' class='name_first' > <input type='text' name='input_1.3' id='input_1_1_3' value='' aria-required='true' /> <label for='input_1_1_3' >First</label> </span> <span id='input_1_1_6_container' class='name_last' > <input type='text' name='input_1.6' id='input_1_1_6' value='' aria-required='true' /> <label for='input_1_1_6' >Last</label> </span> </div></li><li id="field_1_2" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_2"><label class='gfield_label' for='input_1_2' >Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_2' id='input_1_2' type='email' value='' class='medium' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_3" class="gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_3"><label class='gfield_label' for='input_1_3' >Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_1_3' type='tel' value='' class='medium' aria-required="true" aria-invalid="false" /></div></li><li id="field_1_4" class="gfield gfield--width-full gf_left_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_4"><label class='gfield_label' for='input_1_4' >Company / Organization<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_1_4' type='text' value='' class='medium' aria-required="true" aria-invalid="false" /> </div></li><li id="field_1_7" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_7"><label class='gfield_label gfield_label_before_complex' >Password<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_complex ginput_container ginput_container_password' id='input_1_7_container'> <span id='input_1_7_1_container' class='ginput_left'> <span class='password_input_container'> <input type='password' name='input_7' id='input_1_7' value='' aria-required="true" aria-invalid="false" /> </span> <label for='input_1_7' >Enter Password</label> </span> <span id='input_1_7_2_container' class='ginput_right'> <span class='password_input_container'> <input type='password' name='input_7_2' id='input_1_7_2' value='' aria-required="true" aria-invalid="false" /> </span> <label for='input_1_7_2' >Confirm Password</label> </span> <div class='gf_clear gf_clear_complex'></div> </div></li><li id="field_1_19" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_19"><h2 class="gsection_title"></h2></li><li id="field_1_16" class="gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_16"><label class='gfield_label gfield_label_before_complex' >Home Address<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label> <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address' id='input_1_16' > <span class='ginput_full address_line_1 ginput_address_line_1' id='input_1_16_1_container' > <input type='text' name='input_16.1' id='input_1_16_1' value='' aria-required='true' /> <label for='input_1_16_1' id='input_1_16_1_label' >Street Address</label> </span><span class='ginput_full address_line_2 ginput_address_line_2' id='input_1_16_2_container' > <input type='text' name='input_16.2' id='input_1_16_2' value='' aria-required='false' /> <label for='input_1_16_2' id='input_1_16_2_label' >Address Line 2</label> </span><span class='ginput_left address_city ginput_address_city' id='input_1_16_3_container' > <input type='text' name='input_16.3' id='input_1_16_3' value='' aria-required='true' /> <label for='input_1_16_3' id='input_1_16_3_label' >City</label> </span><span class='ginput_right address_state ginput_address_state' id='input_1_16_4_container' > <input type='text' name='input_16.4' id='input_1_16_4' value='' aria-required='true' /> <label for='input_1_16_4' id='input_1_16_4_label' >State / Province / Region</label> </span><span class='ginput_left address_zip ginput_address_zip' id='input_1_16_5_container' > <input type='text' name='input_16.5' id='input_1_16_5' value='' aria-required='true' /> <label for='input_1_16_5' id='input_1_16_5_label' >ZIP / Postal Code</label> </span><span class='ginput_right address_country ginput_address_country' id='input_1_16_6_container' > <select name='input_16.6' id='input_1_16_6' aria-required='true' ><option value='' ></option><option value='Afghanistan' >Afghanistan</option><option value='Albania' >Albania</option><option value='Algeria' >Algeria</option><option value='American Samoa' >American Samoa</option><option value='Andorra' >Andorra</option><option value='Angola' >Angola</option><option value='Anguilla' >Anguilla</option><option value='Antarctica' >Antarctica</option><option value='Antigua and Barbuda' >Antigua and Barbuda</option><option value='Argentina' >Argentina</option><option value='Armenia' >Armenia</option><option value='Aruba' >Aruba</option><option value='Australia' >Australia</option><option value='Austria' >Austria</option><option value='Azerbaijan' >Azerbaijan</option><option value='Bahamas' >Bahamas</option><option value='Bahrain' >Bahrain</option><option value='Bangladesh' >Bangladesh</option><option value='Barbados' >Barbados</option><option value='Belarus' >Belarus</option><option value='Belgium' >Belgium</option><option value='Belize' >Belize</option><option value='Benin' >Benin</option><option value='Bermuda' >Bermuda</option><option value='Bhutan' >Bhutan</option><option value='Bolivia' >Bolivia</option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba</option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina</option><option value='Botswana' >Botswana</option><option value='Bouvet Island' >Bouvet Island</option><option value='Brazil' >Brazil</option><option value='British Indian Ocean Territory' >British Indian Ocean Territory</option><option value='Brunei Darussalam' >Brunei Darussalam</option><option value='Bulgaria' >Bulgaria</option><option value='Burkina Faso' >Burkina Faso</option><option value='Burundi' >Burundi</option><option value='Cabo Verde' >Cabo Verde</option><option value='Cambodia' >Cambodia</option><option value='Cameroon' >Cameroon</option><option value='Canada' >Canada</option><option value='Cayman Islands' >Cayman Islands</option><option value='Central African Republic' >Central African Republic</option><option value='Chad' >Chad</option><option value='Chile' >Chile</option><option value='China' >China</option><option value='Christmas Island' >Christmas Island</option><option value='Cocos Islands' >Cocos Islands</option><option value='Colombia' >Colombia</option><option value='Comoros' >Comoros</option><option value='Congo' >Congo</option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the</option><option value='Cook Islands' >Cook Islands</option><option value='Costa Rica' >Costa Rica</option><option value='Croatia' >Croatia</option><option value='Cuba' >Cuba</option><option value='Curaçao' >Curaçao</option><option value='Cyprus' >Cyprus</option><option value='Czechia' >Czechia</option><option value='Côte d&#039;Ivoire' >Côte d&#039;Ivoire</option><option value='Denmark' >Denmark</option><option value='Djibouti' >Djibouti</option><option value='Dominica' >Dominica</option><option value='Dominican Republic' >Dominican Republic</option><option value='Ecuador' >Ecuador</option><option value='Egypt' >Egypt</option><option value='El Salvador' >El Salvador</option><option value='Equatorial Guinea' >Equatorial Guinea</option><option value='Eritrea' >Eritrea</option><option value='Estonia' >Estonia</option><option value='Eswatini' >Eswatini</option><option value='Ethiopia' >Ethiopia</option><option value='Falkland Islands' >Falkland Islands</option><option value='Faroe Islands' >Faroe Islands</option><option value='Fiji' >Fiji</option><option value='Finland' >Finland</option><option value='France' >France</option><option value='French Guiana' >French Guiana</option><option value='French Polynesia' >French Polynesia</option><option value='French Southern Territories' >French Southern Territories</option><option value='Gabon' >Gabon</option><option value='Gambia' >Gambia</option><option value='Georgia' >Georgia</option><option value='Germany' >Germany</option><option value='Ghana' >Ghana</option><option value='Gibraltar' >Gibraltar</option><option value='Greece' >Greece</option><option value='Greenland' >Greenland</option><option value='Grenada' >Grenada</option><option value='Guadeloupe' >Guadeloupe</option><option value='Guam' >Guam</option><option value='Guatemala' >Guatemala</option><option value='Guernsey' >Guernsey</option><option value='Guinea' >Guinea</option><option value='Guinea-Bissau' >Guinea-Bissau</option><option value='Guyana' >Guyana</option><option value='Haiti' >Haiti</option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands</option><option value='Holy See' >Holy See</option><option value='Honduras' >Honduras</option><option value='Hong Kong' >Hong Kong</option><option value='Hungary' >Hungary</option><option value='Iceland' >Iceland</option><option value='India' >India</option><option value='Indonesia' >Indonesia</option><option value='Iran' >Iran</option><option value='Iraq' >Iraq</option><option value='Ireland' >Ireland</option><option value='Isle of Man' >Isle of Man</option><option value='Israel' >Israel</option><option value='Italy' >Italy</option><option value='Jamaica' >Jamaica</option><option value='Japan' >Japan</option><option value='Jersey' >Jersey</option><option value='Jordan' >Jordan</option><option value='Kazakhstan' >Kazakhstan</option><option value='Kenya' >Kenya</option><option value='Kiribati' >Kiribati</option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of</option><option value='Korea, Republic of' >Korea, Republic of</option><option value='Kuwait' >Kuwait</option><option value='Kyrgyzstan' >Kyrgyzstan</option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic</option><option value='Latvia' >Latvia</option><option value='Lebanon' >Lebanon</option><option value='Lesotho' >Lesotho</option><option value='Liberia' >Liberia</option><option value='Libya' >Libya</option><option value='Liechtenstein' >Liechtenstein</option><option value='Lithuania' >Lithuania</option><option value='Luxembourg' >Luxembourg</option><option value='Macao' >Macao</option><option value='Madagascar' >Madagascar</option><option value='Malawi' >Malawi</option><option value='Malaysia' >Malaysia</option><option value='Maldives' >Maldives</option><option value='Mali' >Mali</option><option value='Malta' >Malta</option><option value='Marshall Islands' >Marshall Islands</option><option value='Martinique' >Martinique</option><option value='Mauritania' >Mauritania</option><option value='Mauritius' >Mauritius</option><option value='Mayotte' >Mayotte</option><option value='Mexico' >Mexico</option><option value='Micronesia' >Micronesia</option><option value='Moldova' >Moldova</option><option value='Monaco' >Monaco</option><option value='Mongolia' >Mongolia</option><option value='Montenegro' >Montenegro</option><option value='Montserrat' >Montserrat</option><option value='Morocco' >Morocco</option><option value='Mozambique' >Mozambique</option><option value='Myanmar' >Myanmar</option><option value='Namibia' >Namibia</option><option value='Nauru' >Nauru</option><option value='Nepal' >Nepal</option><option value='Netherlands' >Netherlands</option><option value='New Caledonia' >New Caledonia</option><option value='New Zealand' >New Zealand</option><option value='Nicaragua' >Nicaragua</option><option value='Niger' >Niger</option><option value='Nigeria' >Nigeria</option><option value='Niue' >Niue</option><option value='Norfolk Island' >Norfolk Island</option><option value='North Macedonia' >North Macedonia</option><option value='Northern Mariana Islands' >Northern Mariana Islands</option><option value='Norway' >Norway</option><option value='Oman' >Oman</option><option value='Pakistan' >Pakistan</option><option value='Palau' >Palau</option><option value='Palestine, State of' >Palestine, State of</option><option value='Panama' >Panama</option><option value='Papua New Guinea' >Papua New Guinea</option><option value='Paraguay' >Paraguay</option><option value='Peru' >Peru</option><option value='Philippines' >Philippines</option><option value='Pitcairn' >Pitcairn</option><option value='Poland' >Poland</option><option value='Portugal' >Portugal</option><option value='Puerto Rico' >Puerto Rico</option><option value='Qatar' >Qatar</option><option value='Romania' >Romania</option><option value='Russian Federation' >Russian Federation</option><option value='Rwanda' >Rwanda</option><option value='Réunion' >Réunion</option><option value='Saint Barthélemy' >Saint Barthélemy</option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha</option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis</option><option value='Saint Lucia' >Saint Lucia</option><option value='Saint Martin' >Saint Martin</option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon</option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines</option><option value='Samoa' >Samoa</option><option value='San Marino' >San Marino</option><option value='Sao Tome and Principe' >Sao Tome and Principe</option><option value='Saudi Arabia' >Saudi Arabia</option><option value='Senegal' >Senegal</option><option value='Serbia' >Serbia</option><option value='Seychelles' >Seychelles</option><option value='Sierra Leone' >Sierra Leone</option><option value='Singapore' >Singapore</option><option value='Sint Maarten' >Sint Maarten</option><option value='Slovakia' >Slovakia</option><option value='Slovenia' >Slovenia</option><option value='Solomon Islands' >Solomon Islands</option><option value='Somalia' >Somalia</option><option value='South Africa' >South Africa</option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands</option><option value='South Sudan' >South Sudan</option><option value='Spain' >Spain</option><option value='Sri Lanka' >Sri Lanka</option><option value='Sudan' >Sudan</option><option value='Suriname' >Suriname</option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen</option><option value='Sweden' >Sweden</option><option value='Switzerland' >Switzerland</option><option value='Syria Arab Republic' >Syria Arab Republic</option><option value='Taiwan' >Taiwan</option><option value='Tajikistan' >Tajikistan</option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of</option><option value='Thailand' >Thailand</option><option value='Timor-Leste' >Timor-Leste</option><option value='Togo' >Togo</option><option value='Tokelau' >Tokelau</option><option value='Tonga' >Tonga</option><option value='Trinidad and Tobago' >Trinidad and Tobago</option><option value='Tunisia' >Tunisia</option><option value='Turkmenistan' >Turkmenistan</option><option value='Turks and Caicos Islands' >Turks and Caicos Islands</option><option value='Tuvalu' >Tuvalu</option><option value='Türkiye' >Türkiye</option><option value='US Minor Outlying Islands' >US Minor Outlying Islands</option><option value='Uganda' >Uganda</option><option value='Ukraine' >Ukraine</option><option value='United Arab Emirates' >United Arab Emirates</option><option value='United Kingdom' >United Kingdom</option><option value='United States' selected='selected'>United States</option><option value='Uruguay' >Uruguay</option><option value='Uzbekistan' >Uzbekistan</option><option value='Vanuatu' >Vanuatu</option><option value='Venezuela' >Venezuela</option><option value='Viet Nam' >Viet Nam</option><option value='Virgin Islands, British' >Virgin Islands, British</option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.</option><option value='Wallis and Futuna' >Wallis and Futuna</option><option value='Western Sahara' >Western Sahara</option><option value='Yemen' >Yemen</option><option value='Zambia' >Zambia</option><option value='Zimbabwe' >Zimbabwe</option><option value='Åland Islands' >Åland Islands</option></select> <label for='input_1_16_6' id='input_1_16_6_label' >Country</label> </span> <div class='gf_clear gf_clear_complex'></div> </div></li><li id="field_1_17" class="gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_17"><label class='gfield_label gfield_label_before_complex' >Work Address<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label> <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address' id='input_1_17' > <span class='ginput_full address_line_1 ginput_address_line_1' id='input_1_17_1_container' > <input type='text' name='input_17.1' id='input_1_17_1' value='' aria-required='true' /> <label for='input_1_17_1' id='input_1_17_1_label' >Street Address</label> </span><span class='ginput_full address_line_2 ginput_address_line_2' id='input_1_17_2_container' > <input type='text' name='input_17.2' id='input_1_17_2' value='' aria-required='false' /> <label for='input_1_17_2' id='input_1_17_2_label' >Address Line 2</label> </span><span class='ginput_left address_city ginput_address_city' id='input_1_17_3_container' > <input type='text' name='input_17.3' id='input_1_17_3' value='' aria-required='true' /> <label for='input_1_17_3' id='input_1_17_3_label' >City</label> </span><span class='ginput_right address_state ginput_address_state' id='input_1_17_4_container' > <input type='text' name='input_17.4' id='input_1_17_4' value='' aria-required='true' /> <label for='input_1_17_4' id='input_1_17_4_label' >State / Province / Region</label> </span><span class='ginput_left address_zip ginput_address_zip' id='input_1_17_5_container' > <input type='text' name='input_17.5' id='input_1_17_5' value='' aria-required='true' /> <label for='input_1_17_5' id='input_1_17_5_label' >ZIP / Postal Code</label> </span><span class='ginput_right address_country ginput_address_country' id='input_1_17_6_container' > <select name='input_17.6' id='input_1_17_6' aria-required='true' ><option value='' ></option><option value='Afghanistan' >Afghanistan</option><option value='Albania' >Albania</option><option value='Algeria' >Algeria</option><option value='American Samoa' >American Samoa</option><option value='Andorra' >Andorra</option><option value='Angola' >Angola</option><option value='Anguilla' >Anguilla</option><option value='Antarctica' >Antarctica</option><option value='Antigua and Barbuda' >Antigua and Barbuda</option><option value='Argentina' >Argentina</option><option value='Armenia' >Armenia</option><option value='Aruba' >Aruba</option><option value='Australia' >Australia</option><option value='Austria' >Austria</option><option value='Azerbaijan' >Azerbaijan</option><option value='Bahamas' >Bahamas</option><option value='Bahrain' >Bahrain</option><option value='Bangladesh' >Bangladesh</option><option value='Barbados' >Barbados</option><option value='Belarus' >Belarus</option><option value='Belgium' >Belgium</option><option value='Belize' >Belize</option><option value='Benin' >Benin</option><option value='Bermuda' >Bermuda</option><option value='Bhutan' >Bhutan</option><option value='Bolivia' >Bolivia</option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba</option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina</option><option value='Botswana' >Botswana</option><option value='Bouvet Island' >Bouvet Island</option><option value='Brazil' >Brazil</option><option value='British Indian Ocean Territory' >British Indian Ocean Territory</option><option value='Brunei Darussalam' >Brunei Darussalam</option><option value='Bulgaria' >Bulgaria</option><option value='Burkina Faso' >Burkina Faso</option><option value='Burundi' >Burundi</option><option value='Cabo Verde' >Cabo Verde</option><option value='Cambodia' >Cambodia</option><option value='Cameroon' >Cameroon</option><option value='Canada' >Canada</option><option value='Cayman Islands' >Cayman Islands</option><option value='Central African Republic' >Central African Republic</option><option value='Chad' >Chad</option><option value='Chile' >Chile</option><option value='China' >China</option><option value='Christmas Island' >Christmas Island</option><option value='Cocos Islands' >Cocos Islands</option><option value='Colombia' >Colombia</option><option value='Comoros' >Comoros</option><option value='Congo' >Congo</option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the</option><option value='Cook Islands' >Cook Islands</option><option value='Costa Rica' >Costa Rica</option><option value='Croatia' >Croatia</option><option value='Cuba' >Cuba</option><option value='Curaçao' >Curaçao</option><option value='Cyprus' >Cyprus</option><option value='Czechia' >Czechia</option><option value='Côte d&#039;Ivoire' >Côte d&#039;Ivoire</option><option value='Denmark' >Denmark</option><option value='Djibouti' >Djibouti</option><option value='Dominica' >Dominica</option><option value='Dominican Republic' >Dominican Republic</option><option value='Ecuador' >Ecuador</option><option value='Egypt' >Egypt</option><option value='El Salvador' >El Salvador</option><option value='Equatorial Guinea' >Equatorial Guinea</option><option value='Eritrea' >Eritrea</option><option value='Estonia' >Estonia</option><option value='Eswatini' >Eswatini</option><option value='Ethiopia' >Ethiopia</option><option value='Falkland Islands' >Falkland Islands</option><option value='Faroe Islands' >Faroe Islands</option><option value='Fiji' >Fiji</option><option value='Finland' >Finland</option><option value='France' >France</option><option value='French Guiana' >French Guiana</option><option value='French Polynesia' >French Polynesia</option><option value='French Southern Territories' >French Southern Territories</option><option value='Gabon' >Gabon</option><option value='Gambia' >Gambia</option><option value='Georgia' >Georgia</option><option value='Germany' >Germany</option><option value='Ghana' >Ghana</option><option value='Gibraltar' >Gibraltar</option><option value='Greece' >Greece</option><option value='Greenland' >Greenland</option><option value='Grenada' >Grenada</option><option value='Guadeloupe' >Guadeloupe</option><option value='Guam' >Guam</option><option value='Guatemala' >Guatemala</option><option value='Guernsey' >Guernsey</option><option value='Guinea' >Guinea</option><option value='Guinea-Bissau' >Guinea-Bissau</option><option value='Guyana' >Guyana</option><option value='Haiti' >Haiti</option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands</option><option value='Holy See' >Holy See</option><option value='Honduras' >Honduras</option><option value='Hong Kong' >Hong Kong</option><option value='Hungary' >Hungary</option><option value='Iceland' >Iceland</option><option value='India' >India</option><option value='Indonesia' >Indonesia</option><option value='Iran' >Iran</option><option value='Iraq' >Iraq</option><option value='Ireland' >Ireland</option><option value='Isle of Man' >Isle of Man</option><option value='Israel' >Israel</option><option value='Italy' >Italy</option><option value='Jamaica' >Jamaica</option><option value='Japan' >Japan</option><option value='Jersey' >Jersey</option><option value='Jordan' >Jordan</option><option value='Kazakhstan' >Kazakhstan</option><option value='Kenya' >Kenya</option><option value='Kiribati' >Kiribati</option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of</option><option value='Korea, Republic of' >Korea, Republic of</option><option value='Kuwait' >Kuwait</option><option value='Kyrgyzstan' >Kyrgyzstan</option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic</option><option value='Latvia' >Latvia</option><option value='Lebanon' >Lebanon</option><option value='Lesotho' >Lesotho</option><option value='Liberia' >Liberia</option><option value='Libya' >Libya</option><option value='Liechtenstein' >Liechtenstein</option><option value='Lithuania' >Lithuania</option><option value='Luxembourg' >Luxembourg</option><option value='Macao' >Macao</option><option value='Madagascar' >Madagascar</option><option value='Malawi' >Malawi</option><option value='Malaysia' >Malaysia</option><option value='Maldives' >Maldives</option><option value='Mali' >Mali</option><option value='Malta' >Malta</option><option value='Marshall Islands' >Marshall Islands</option><option value='Martinique' >Martinique</option><option value='Mauritania' >Mauritania</option><option value='Mauritius' >Mauritius</option><option value='Mayotte' >Mayotte</option><option value='Mexico' >Mexico</option><option value='Micronesia' >Micronesia</option><option value='Moldova' >Moldova</option><option value='Monaco' >Monaco</option><option value='Mongolia' >Mongolia</option><option value='Montenegro' >Montenegro</option><option value='Montserrat' >Montserrat</option><option value='Morocco' >Morocco</option><option value='Mozambique' >Mozambique</option><option value='Myanmar' >Myanmar</option><option value='Namibia' >Namibia</option><option value='Nauru' >Nauru</option><option value='Nepal' >Nepal</option><option value='Netherlands' >Netherlands</option><option value='New Caledonia' >New Caledonia</option><option value='New Zealand' >New Zealand</option><option value='Nicaragua' >Nicaragua</option><option value='Niger' >Niger</option><option value='Nigeria' >Nigeria</option><option value='Niue' >Niue</option><option value='Norfolk Island' >Norfolk Island</option><option value='North Macedonia' >North Macedonia</option><option value='Northern Mariana Islands' >Northern Mariana Islands</option><option value='Norway' >Norway</option><option value='Oman' >Oman</option><option value='Pakistan' >Pakistan</option><option value='Palau' >Palau</option><option value='Palestine, State of' >Palestine, State of</option><option value='Panama' >Panama</option><option value='Papua New Guinea' >Papua New Guinea</option><option value='Paraguay' >Paraguay</option><option value='Peru' >Peru</option><option value='Philippines' >Philippines</option><option value='Pitcairn' >Pitcairn</option><option value='Poland' >Poland</option><option value='Portugal' >Portugal</option><option value='Puerto Rico' >Puerto Rico</option><option value='Qatar' >Qatar</option><option value='Romania' >Romania</option><option value='Russian Federation' >Russian Federation</option><option value='Rwanda' >Rwanda</option><option value='Réunion' >Réunion</option><option value='Saint Barthélemy' >Saint Barthélemy</option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha</option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis</option><option value='Saint Lucia' >Saint Lucia</option><option value='Saint Martin' >Saint Martin</option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon</option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines</option><option value='Samoa' >Samoa</option><option value='San Marino' >San Marino</option><option value='Sao Tome and Principe' >Sao Tome and Principe</option><option value='Saudi Arabia' >Saudi Arabia</option><option value='Senegal' >Senegal</option><option value='Serbia' >Serbia</option><option value='Seychelles' >Seychelles</option><option value='Sierra Leone' >Sierra Leone</option><option value='Singapore' >Singapore</option><option value='Sint Maarten' >Sint Maarten</option><option value='Slovakia' >Slovakia</option><option value='Slovenia' >Slovenia</option><option value='Solomon Islands' >Solomon Islands</option><option value='Somalia' >Somalia</option><option value='South Africa' >South Africa</option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands</option><option value='South Sudan' >South Sudan</option><option value='Spain' >Spain</option><option value='Sri Lanka' >Sri Lanka</option><option value='Sudan' >Sudan</option><option value='Suriname' >Suriname</option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen</option><option value='Sweden' >Sweden</option><option value='Switzerland' >Switzerland</option><option value='Syria Arab Republic' >Syria Arab Republic</option><option value='Taiwan' >Taiwan</option><option value='Tajikistan' >Tajikistan</option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of</option><option value='Thailand' >Thailand</option><option value='Timor-Leste' >Timor-Leste</option><option value='Togo' >Togo</option><option value='Tokelau' >Tokelau</option><option value='Tonga' >Tonga</option><option value='Trinidad and Tobago' >Trinidad and Tobago</option><option value='Tunisia' >Tunisia</option><option value='Turkmenistan' >Turkmenistan</option><option value='Turks and Caicos Islands' >Turks and Caicos Islands</option><option value='Tuvalu' >Tuvalu</option><option value='Türkiye' >Türkiye</option><option value='US Minor Outlying Islands' >US Minor Outlying Islands</option><option value='Uganda' >Uganda</option><option value='Ukraine' >Ukraine</option><option value='United Arab Emirates' >United Arab Emirates</option><option value='United Kingdom' >United Kingdom</option><option value='United States' selected='selected'>United States</option><option value='Uruguay' >Uruguay</option><option value='Uzbekistan' >Uzbekistan</option><option value='Vanuatu' >Vanuatu</option><option value='Venezuela' >Venezuela</option><option value='Viet Nam' >Viet Nam</option><option value='Virgin Islands, British' >Virgin Islands, British</option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.</option><option value='Wallis and Futuna' >Wallis and Futuna</option><option value='Western Sahara' >Western Sahara</option><option value='Yemen' >Yemen</option><option value='Zambia' >Zambia</option><option value='Zimbabwe' >Zimbabwe</option><option value='Åland Islands' >Åland Islands</option></select> <label for='input_1_17_6' id='input_1_17_6_label' >Country</label> </span> <div class='gf_clear gf_clear_complex'></div> </div></li><li id="field_1_20" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_20"><h2 class="gsection_title"></h2></li><li id="field_1_14" class="gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_14"><label class='gfield_label gfield_label_before_complex' >Are you of Hispanic/Latino/Spanish origin?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_1_14'><li class='gchoice gchoice_1_14_1'> <input class='gfield-choice-input' name='input_14.1' type='checkbox' value='Yes' id='choice_1_14_1' /> <label for='choice_1_14_1' id='label_1_14_1'>Yes</label> </li><li class='gchoice gchoice_1_14_2'> <input class='gfield-choice-input' name='input_14.2' type='checkbox' value='No' id='choice_1_14_2' /> <label for='choice_1_14_2' id='label_1_14_2'>No</label> </li></ul></div></li><li id="field_1_15" class="gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_1_15"><label class='gfield_label gfield_label_before_complex' >How would you best describe yourself?</label><div class='ginput_container 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All copyrights, trademarks, content, business methods, graphics, designs and documents posted on this website, as well as the look and feel of this website ("Intellectual Property") are the property of the Hope and Healing Center & Institute.<br /> <br /> The user may download one copy of the materials on any single computer and print a copy of the materials solely for use in learning about or utilizing Gateway to Hope's training materials and resources. The user may not otherwise copy, print, reproduce, distribute, transmit, upload, download, store, use, or change the materials. 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