DC Mutual Aid - Support for Individuals
Please fill out this form so that we can pair you with a provider that best fits your needs.

Please know that the most of our providers are trauma based, socially conscious and work from a transformative practice. We provide care that is accessible, POC/indigenous culture affirming, all gender-loving, all body positive and loving, intergenerational and ablism supported.

All questions are not required but for those questions that are please answer clearly so that we may find the provider that best fits your ask. We want to make sure you get the most from your session.

If you have any questions or difficulty with filling out the form, please let us know by sending us an email at healersforliberationnetwork@gmail.com.

To learn more about the Healers For Liberation Network D.C. feel free to visit our website: https://healersforliberation.wixsite.com/freedom
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Name *
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Pronouns
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How do you identify in race/ethnicity?
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What brought you to here today? *Remember to breathe deeply* *
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What type of session do you prefer? *
How would you like to connect with your provider? *
Do you prefer a provider who identifies as? *
Do you have a preference in the type of service you receive? (LGBTQI friendly, elder friendly, spiritual, art therapy, movement therapy, bodywork, etc.)
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Whats the best way we can get in contact you? (Email, Phone, etc) *
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