Professor’s Complimentary Copy Request Form

co-creating-change-smallPlease consider adopting this vibrant new text for your course. We know both you and your students will appreciate the value and insight this text will bring to your clinical course.

To order your review copy of Co-Creating Change: Effective Dynamic Therapy Techniques please mail this form to Seven Leaves Press, 4520 Main Street, Suite 700, Kansas City, Missouri 64111, or fax it to (949) 581-4958, or submit the on-line form below.

All information must be provided for your request to be considered.

Your Name

Your Title



Street address

City, state, and zip code

Your Email

Office phone

Is this decision individual or committee?

 Individual Committee

Other members of this committee who should receive a copy of this book

Title of course

Number of students

Number of sections

Adoption decision date

Likelihood of change

 Excellent Good Fair Not likely

College/university bookstore/textbook buyer’s name

Phone number


Upon receipt of the complimentary copy, I agree to review your book and consider it for adoption. If I adopt the book I will contact my bookstore and request that it order the book in sufficient quantity for my class. If this book is positively reviewed but not adopted, I agree to recommend it to my students for bookstore and/or library purchase.

 yes no

Please type the text shown