Uncovering Possibility in the Dark Application

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This form is meant to provide some reflection and insight into your participation in this 12 week somatic healing group focusing on developing our capacity to dream and to vision. Thanks for taking the time to thoughtfully answer all questions. Participants will be notified of their acceptance into the group as soon as possible after application. Applications are due by December 24th, but applying early is recommended. If group is full, you will be notified and placed on a waitlist. If you have any questions please feel free to email me at brooke@haveheartwellness.com.

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Διεύθυνση ηλεκτρονικού ταχυδρομείου *

Name *

Email Address *

Phone *

What are your pronouns? *

How'd you hear about the group? Who referred you? *

What has you interested in Uncovering Possibility? What draws you to participate in this group? What are you hoping to transform through your participation? *

How do you identify in terms of race, body size, class, gender, sexuality, etc? What communities are you a part of? *

What has your healing work looked like up to this point? How much intentional healing have you done? *

What is your support system like? How supported do you feel? This may include people, pets, spiritual, religious or embodied practices, meds/supplements, etc. *

How are you in groups? What kind of positive feedback do you get from others in groups? What about negative? How do you take feedback when you receive it? What edges do you anticipate bumping up against in this group? *

What do you know about how you show up under pressure? What do you know about what you do when things feel hard? What do you know how to do to take care of yourself in these moments? *

This group is a 12 week offering that meets Tuesday evenings January 19th-April 6th. It is expected that participants attend all 12 sessions. Do you foresee anything getting in the way of that? What might you do to resource yourself to show up for all 12 weeks? *

Do you have any access needs that I should know about? What helps you feel as safe and present as possible, especially in an online/video context? You're 100% at choice in what you share here. *

Uncovering Possibility costs $85/week or $1020. Enrollment is for the whole group only. You are expected to pay the entirety of the group fee regardless of how many sessions you attend. *

I understand this payment structure and understand that I will be charged $1020 regardless of how many sessions I am able to attend.

There are 3 reduced fee spaces available. These spaces are reserved for QTBIPOC. There are 2 $50/week spaces and 1 $65/week space available. Would you like to request access to these reduced fee spaces? Will you be able to participate if you don't have access to these funds? Please describe your class background and current class experience.

Various payment plans are available. All participants will be charged a minimum of $85 or your weekly session fee to reserve space. Which would you prefer?

I would prefer to be charged weekly

In 3 equal payments charged monthly

In 2 equal payments

In 1 lump sum

Διαγραφή επιλογής

We will gather for group practice weekly. You will receive homework and practices to be done on your own or with other participants. It is expected that you show up to group on time and ready to practice right at 6:30. It is expected that you show up to every group. All absences must be negotiated with Brooke prior to start of group. You and your presence at every meeting are invaluable to the group process! *

I understand and agree to participation in and outside of sessions. I understand that my participation is vital to creating the necessary container to do this work and that this outside work is just as valuable as my time in session

Uncovering Possibility is highly experiential. We will work to actively feel into our bodies every week, often contacting difficult histories. A big part or our work will be to contact resilience in order to hold these histories, AND it is important to know that this is an experiential somatic trauma healing group. *

I understand and agree to be self responsive and let Brooke, my support system and other group participants know my needs as necessary

Our communities are often very small. Do you have any current conflicts I should know about? Are there any people you do not share space with? Please keep disclosures to "headline-level" summaries. I don't need every detail. We can arrange to talk more as needed.

Brooke Stepp is a certified nutritionist and licensed mental health counselor in Washington. As facilitator of this group, Brooke is not entering into a therapeutic relationship with you. They are serving as a guide, a facilitator, and at times a coach in your own healing.

I understand that Brooke is not my therapist and that my participation in this group does not constitute a therapeutic relationship

Διαγραφή επιλογής

Anything else you want me to know?

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