1:1 Sessions - Expression of Interest
Thank you for your interest in inviting me in to support you. I look forward to learning more about what your hopes are. Please take a moment to read the following and fill out this form, and I will be in touch as soon as possible. Thank you.

Sessions are $150/hr.
Financial Access: I have 1 spot currently open on sliding scale, between $110-$150. There is a place in this form to request a sliding scale spot if you need.

Those residing in Canada pay in CAD$ by email transfer, and those residing anywhere else pay USD$ by Paypal.

Please note: currently, I am holding sessions mainly on Tuesday mornings, Wednesdays and Thursdays with a few other openings sprinkled in on other days.

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Email *
Name & Pronouns
Most generally, what kind of support session are you interested in?
Please let me know more specifically your hopes for our time together.  
Please let me know what you are hoping for in terms of number of sessions and frequency of sessions. Of course things can change, and its ok if this is just a roundabout idea.
Have we worked together before? Please check which Sacred Grief offerings you have participated in before if so, or that this would be our first time. Thanks.
Do you have any accessibility needs that you want me to be aware of?
If you require a financial access spot, please let me know in one sentence why you need this, and what amount you are able to pay on the sliding scale of $110-$150.
Please indicate which currency you will be paying. (Those residing in Canada, CAD currency, those residing outside Canada, USD currency)
Consent and Liability Waiver Agreement:

I understand that participating in 1:1 sessions through Sacred Grief - Shauna Janz is for educational, therapeutic, mentoring and healing purposes, however it is not clinical therapy, trauma therapy, or mental health counseling. I understand I might experience some emotional, mental, spiritual or physical learning edges or stress (growing pains) and that participating in 1:1 sessions with Sacred Grief - Shauna Janz may facilitate personal change and growth. I agree that I have other resources and professionals for support with trauma symptoms or mental health care should I need this.

I agree willingly to release from any claim Sacred Grief- Shauna Janz from responsibility for any of the possible learning edges or stress responses aforementioned.
Is there anything else you would like me to know about you?
A copy of your responses will be emailed to the address you provided.
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