JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
BAREFOOT BROTHERS 2021 - '6 Week Course'
Fill out this form to get a free video consult to see if you're a good fit for this course
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name
*
Your answer
Email Address
*
Your answer
Mobile Phone Number
Your answer
What are you most interested in learning about
Principles of therapy
Principles of Development/growth
Relationships and Communication styles
Coping strategies, childhood trauma, patterns and habits
Somatic/embodied healing work
Cognitive reframing and rewiring of limiting beliefs
Which parts of the course are the most valuable to you
Weekly online group workshops (7 x 90 minutes)
Online portal access with 10+ hours of video content
24 hour chat group (for support and clarifications)
1 on 1 video call with facilitator (90 minutes)
Which aspect of the self do you want to work on most
Mental
Physical
Emotional
Spiritual
Which area of life do you want to work on most
Relationships and Social
Career, business, and finance
Health
What area of life is your biggest issue/block
Dating, sex, relationships
Business, finance, career
Health
What is your biggest issue/block is related to?
Self worth
Safety or Security
Other:
What is your major mental wound associated to?
Humiliation
Betrayal
Rejection
Abandonment
Injustice
Other:
What is the main coping strategies you use ?
Anxiety or freezing
Avoidance or aloofness
Denial or repression
Anger and hostility
What are you looking to get out of this course?
Your answer
Any other comments?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
