Birth Healing Intensive Application

Thank you for your interest in the Birth Healing Intensive! I am honored you have chosen this program to help you ignite your magic and get you to where you want to go both personally and professionally. I look forward to the journey ahead with you!

As this is a 9-month intensive program and both a professional and personal commitment, I want to make sure the Intensive fits what you are looking for in terms of support and future goals. Please fill out the application below in its entirety to the best of your ability. As a note, these questions are designed to gain a better understanding of your experience, the support you may need, and the tools that will best help you in this program. Please reach out if you have any questions.

Next Steps After Completing This Application:

You will receive an email in follow up after I review your application (usually within 72 hours or less).
If this program is a match to help you achieve your personal and professional goals, you will receive a link to schedule a call with me (we will discuss your goals in more detail and make sure that any questions you have are answered).
You will, then, receive information to register and secure your spot in the intensive!

Birth Healing Intensive Application

Name(Required)

First Last

Email(Required)

Phone(Required)

State/Territory and Country(Required)

Occupation(Required)

License Number(Required)

How many years have you been in this occupation?(Required)

What struggles or challenges are you facing right now that you hope this program will help with?(Required)

What is your experience in sensing the energy flow of the body? Is this new for you or do you have a sense of it?(Required)

What myofascial release or craniosacral therapy courses have you taken? What is your experience with these practices?(Required)

Have you had any Somatic Experiencing, Somato Emotional Release, and/or Myofasical Release work done with you?(Required)

Have you done individual therapy with a counselor or therapist?(Required)

How supportive has the therapy been for you?(Required)

How connected or in tune with your body are you?(Required)

How well do you notice and express your emotions?(Required)

What is one personal issue you want to work on for yourself?(Required)

Describe any spiritual/religious practices that you do/follow and/or believe? Are you agnostic/atheist? Do you pray frequently, go to church, meditate, have a connection to any spiritual guides/angels?(Required)

What’s the biggest takeaway you hope to get out of doing this program?(Required)