InnerSpace Integration Support Providers Network Application
Hi! We are excited that you are interested in joining the InnerSpace Integration Support Providers Network. Our goal is to connect the community to therapists, counselors, coaches, and healers in Southern California that are experienced with psychedelic/entheogenic integration. Please share your motivation to work with us, your background and credentials, and your experience with non-ordinary states of consciousness. We look forward to collaborating with you!
First Name *
Last Name *
Email *
Phone Number *
City of Residence *
Please specific area/neighborhood
Website (this will be what we link to on our site) *
Why are you interested in being a part of InnerSpace Integration?
What experience do you have working with psychedelics/entheogens?
What experience do you have providing support to people preparing for or integrating from non-ordinary states of consciousness?
What healing modalities do you work with?
What kind of professional training, certificates, and/or licenses do you hold?
We will ask for copies of this paperwork after your application has been submitted.
Please give a 60 word or less description of you and your working style.
This will be used as your bio on the website if you are accepted.
Please make a bulleted list of the specific services you provide.
This will be used on the website if you are accepted. No more than 5 bullets please.
Would you be interested in organizing and leading local community integration circles?
Submit your headshot *
Please submit file with name formatting: 'LastNameFirstName_headshot.jpeg' to http://tinyurl.com/isisubmitfile
Required
Submit CV/Resume *
Please submit file with name formatting: 'LastNameFirstName_CV.pdf' to http://tinyurl.com/isisubmitfile
Required
By joining the InnerSpace Integration Support Providers Network, you will be included in a hand-curated list of professionals that are aligned with ISI's vision for psychedelic integration. Through our web platform, you will be featured on a special Provider's page where our clients can contact you directly for your services. You will also receive a one-time "Featured Provider" highlight in the monthly newsletter sent to our ISI community. The yearly cost for the feature is $80 plus a 15% commission fee per first service rendered to each client gained through the network. *
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