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Request for Services
Thank you for your interest in services at The Wellness Farm. We are a 2.5-acre therapetuic carefarm with the mission to provide support for grief and trauma and to build resiliency in the community.
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Email
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Are you looking for services for you or someone else?
Myself
My Partner
My Family
My Child(ren)
A Friend
Your First & Last Name
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Phone Number
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How did you hear about us?
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Full Address
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Please indicate the services you are interested in:
Counseling Ages 18+
Farm Helpers Coaching Program for Youth Aged 10-18
Individual or Family Farm Visit - Grief Support Sessions (1-3 hours)
Private Retreat - Extended Family or Larger Group (2-4 hours)
Group Retreat - Participate in one of our Wellness Farm hosted retreats
Divorce Resiliency Support Group
Other:
What do you want us to know about you/your situation? How do you hope The Wellness Farm can support you?
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What is your general availability? Mention days of the week and times of the day you would be available.
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Do you have any physical/medical condition or accessibility needs that would affect participation?
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Are you a Veteran or currently serving in the military? (Please check all that apply)
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Yes, Veteran
Yes, Active Duty
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