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Trauma Awareness, Integration & Healing Circle
Confidential Application for Participation

To ensure safety, continuity, and confidentiality our healing circles will be limited to a maximum of 18 participants. We will meet a minimum of four times a month for six consecutive months. When we have at least 12 people accepted into the program we will start the closed group sessions.

The cost of participating in the group is $150 a month (there will be a limited number of partial scholarships available by application).
  
Thank you for your application to participate in the 6-month Trauma Awareness, Integration, and Healing Circle
With love and gratitude,
Michael 
Please answer the following questions:

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* 1. Why do you want to participate in this program?

Please include your name, phone number and email address.

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* 2. Please describe your experience with personal and familial trauma.

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* 3. Are you willing to commit to participating in this program for six months and attend at least 80% of the sessions?

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* 4. What are some other programs you have participated in that are trauma related?

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* 5. Do you have a regular meditation practice?

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* 6. Describe any triggers, challenges, or habitual patterns that you feel keep you from growing, healing, and integrating traumatic events from the past.

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* 7. Are you willing to keep confidentiality about who is in and what is said in our closed group?

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* 8. What do you need to feel safe in a group setting?

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* 9. Are you currently working with a therapist?

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* 10. Do you have any questions or have anything else you would like to share with us?

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