Recovery Workshop Interest Form

Welcome! This form is the first step in joining the 10-week The PRT Recovery Workshop, a supportive, small-group space for individuals working through chronic symptoms using The Pain Reprocessing Therapy Workbook and other mind-body tools.

Each 90-minute session includes group discussion, breakout reflection, and guided practices. You'll choose one weekly group time that works best for you—either Wednesdays at 7:00 PM PST or Fridays at 11:00 AM PST. Groups are capped at 15 participants to foster connection, safety, and support.

If you haven’t already, you can purchase your copy of The Pain Reprocessing Therapy Workbook here:
👉 Buy the Workbook on New Harbinger

👉 Buy the Workbook on Amazon

After you submit this form, our Intake Coordinator will be in touch within 48 hours (or less) to offer a free screening call, answer any questions, and help confirm whether this group is the right fit for you.

Follow along on Instagram for reminders, updates, and more information about the workshop:
📲 @that.therapist

If you have any questions or concerns in the meantime, feel free to contact our Intake Coordinator, Cindy Castro, at cindy@painpsychologycenter.com.

We’re so glad you’re here.

Please note: This group is a coaching and educational experience—not therapy or medical treatment. It is not a substitute for professional mental health care. If you have medical, psychiatric, or psychological concerns, we encourage you to consult with a licensed healthcare provider.

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Name
Email Address *
Phone Number  *
Location *
Time Zone *
What drew you to The PRT Recovery Workshop? *
Have you read or started The Pain Reprocessing Therapy Workbook? *
Have you done any previous mind-body or pain recovery work? *
Have you participated in a therapy or support group before? *
What are the primary symptoms or challenges you're currently dealing with? *
How long have you been experiencing these symptoms? *
Which group time works best for you? *
Do you have access to a quiet, private space where you can join Zoom calls and participate comfortably? *
Do you understand this is a 10-week commitment, and each session is 90 minutes long with both group and breakout components? *
Do you agree to uphold the confidentiality of all group members, including not sharing names, personal experiences, or anything discussed in the group outside of the workshop space? *
If you join the group, you’ll receive a short set of group agreements (e.g. confidentiality, respect, and participation expectations). Are you willing to sign a group agreement form? *
This is a paid 10-week program with limited spots. Once you commit to your group and submit payment, your spot is held and the payment is non-refundable.
Do you understand and agree to this policy? *

This group is educational and supportive in nature, but it is not a substitute for individual therapy or medical treatment. Do you understand and agree?

 *
Do you have any accessibility needs or accommodations that would help you feel more supported in this group? *
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