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Community Roots Scholarship Application
Thank you for your interest in working together!
In the spirit of my commitment to provide affordable and accessible healthcare and healing, I am excited to offer a community healing scholarship program.
The program provides:
* One coaching/healing session per week (4 sessions total)
* Custom herbs and supplements if applicable
* 25% Discount for any classes I offer during your time in the program
* 10% Discount on future classes and herbs
The program is open to under-resourced LGBTQ+ identified people, BIPOC (Black, Indigenous + People of Color) and survivors of sexual and/or intimate partner violence, who are located in the Southeast, who would not normally be able to afford my rates. I currently have space for one scholarship appointment per week. Please note I do not work with pregnant people or people who are chest/breastfeeding.
Please fill out this form and I will respond within 3 business days via email to schedule a free phone consult to discuss your application. If scholarship appointments are currently filled, I will place you on a wait list and notify you when appointment space becomes available.
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Where are you located (city + state)?
Do you identify as any of the following:
Survivor of Sexual Violence
Survivor of Intimate Partner Violence
How did you hear about this program?
Cazimi Healing Website
What health issues do you need support with?
Why are you interested in a holistic approach?
Are you able to commit to all 4 sessions?
Please share any questions, concerns or thoughts you might have:
Send me a copy of my responses.
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