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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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Email *
Where are you located (city + state)?
Do you identify as any of the following:
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How did you hear about this program?
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Phone number
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?
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Please share any questions, concerns or thoughts you might have:
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