Breaking Free: Re-Membering Your Self -- Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Are you ready to learn and practice healthy relational boundaries within a brave BIPOC only group setting? Together, we explore how we learned to esteem ourselves and others--without needing to disclose any private information. You will leave with a clearer sense of who you are, how you've needed to adapt in order to survive/function, and how to begin to claim your space within a worldview that is grounded in equality, non-violence, freedom, social responsibility, and interdependence. Limited to 12 participants.

Registration not complete until payment in full to save your spot. $775. Early Bird by 1/11: $675. Payment by Paypal (judy@JudyHuCounseling) or Venmo (@judy-hu-4)

Save these dates:
Group Coaching via ZOOM: Sundays 4-5:30pm EST: JAN 29; FEB 5, 12, 26; MAR 5, 12, 26; APR 9 Office Hours with Judy via ZOOM: Fridays noon-1pm EST: FEB 17; MAR 17, 31

Feel free to email with questions: Judy@JudyHuCounseling.com

Or schedule a free 30 min call to see if this group is for you: https://calendly.com/judyhucounseling/breakingfree

Follow me on IG/ FB: @JudyHuCounseling
TikTok: @JudyHuBoundaryCoach
YouTube: What Would Judy Hu Do?

Email *

Full Name *

Email *

Pronouns

Phone Number *

Age (Must be 23+)

Race/Ethnicity - How do you identify? *

While supportive, this group is not intended as therapy. Do you feel like you have enough emotional supports in place, in case you get triggered from the group? *

Yes, I have supports in place that I will access in case I become dysregulated in one of our groups.

No, I am feeling quite emotionally fragile and am not sure I will be emotionally stable enough.

I'm not sure. Can we talk about this?

What do you hope to gain from this group coaching program? What makes you want to join?

Is there a specific struggle/theme you want covered during our time together? (eg. Conflict avoidance, differing parenting style with partner, toxic work environment, etc.)

Is there something you're worried about and want me to know? Eg. Sexual trauma, current stressor, fear of judgment, discomfort with a certain personality, etc. (This information will be confidential.)

How did you hear about Breaking Free? *

Someone who attended before

Judy's Newsletter

Facebook

Instagram

TikTok

Internet search

Other:

Required

Thank you for taking the time to fill out this form. If we haven't talked already, please look out for an email from Judy@JudyHuCounseling to schedule a quick 30 min call to answer any questions, and make sure this will be a good experience for you.

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms