JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Application for Breaking Through Resistance
Sign in to Google
to save your progress.
Learn more
* Required
Email
*
Your email
First + Last Name
*
Your answer
Pronouns
*
Your answer
What made you apply to join the BTR community?
*
Your answer
Describe your current reality
*
Your answer
Health and healing looks different to everyone. What does health and healing look like to you? Where are you in relationship to your view of health and healing?
*
Your answer
Have there been any unique (to you and your family/community) challenges that you've recently had to deal with, or currently are dealing with?
*
Your answer
What is the thing you're most focused on experiencing in the 6-month container?
*
Your answer
In a perfect world, how do I help you reach this reality?
*
Your answer
If something could change in your life TOMORROW(and it be easy!), what would it be?
*
Your answer
Best way to reach you on the internet?
*
Your answer
Is there anything else you would like me to know?
Your answer
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Amy Demone.
Report Abuse
Forms
