Services
Thank you for taking an interest in the Trauma-Informed Services. Please take a moment and fill out this form. You have the option to pay for the service in full or make payments before our appointment. 

 *Sliding scale for those that qualify.

 *Please Note: Before services can begin. A consultation is required if it's your first time working with us. The consultation is 1 hour, the fee must be paid before the initial appointment.

***If working with a minor child, parent or caregiver agrees to learn and enter our parenting education program to give the parent the needed awareness, skills, and tools to help their children properly heal from trauma. ***
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Email *
Name *
Phone number *
Reason for seeking support and services. *
What type of service are you looking for? (A partial scholarship for those that qualify and submit proof of hardship)
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Circle of Care Referral Program If you were referred by someone please let us know by who?
Welcome Wellness Discount: For this discount to be applied an initial consultation must be made. 
Best Day to meet
Mon
Tue
Wed (Available after 2)
Thur (Not available after 6)
Fri (Available after 3)
Sat
Morning 11-1pm
Afternoons 2-4
Evening 5-7
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If the above times don't work, we can work around your schedule
Please let us know, how you would like to meet? *Our locations are in the San Fernando, CA area. *
Required
Seeking services for Children
This is for individual healing art classes.
If seeking services for a minor are you willing to take our parenting class series to understand the behavior of the child that has experienced trauma.
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Are you in need of a sliding scale? (Proof of income must be provided)  *
Required
If requesting for a sliding scale your consultation fee would be reduced. If you aren't able to pay this amount please state what amount you are able to pay for the consultation.
Documentation to provide proof of hardship. Any of these:
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Did you submit proof?
How will you be paying for services? (Zelle or Paypal) 
If you aren't able to pay in full, but are able to make payment installments. How much can you make each month? (Payments need to be made each time before we meet.
***please note: this is only for survivors that are unable to pay due to living in a shelter, being homeless or not having enough funds to pay for services.*** I am requesting a scholarship because: (let us know the hardship and paperwork documentation must be submitted)
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