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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 if applicable
* Free entry to any classes I offer during your time in the program
* 10% Discount on future appointments, classes and herbs

The program is open to low income LGBTQ+ identified people and people of color who would not normally be able to afford my rates. I currently have space for one scholarship appointment per week.

Please fill out this form and I will respond within 3 business days 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.
Email address *
How did you hear about this program?
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Phone number
What do you need support with?
Why is this option right for you?
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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