Application for Trauma Integration Circle
Email *
Email Address: *
First and Last Name: *
Address: *
Cell Phone Number: *
Birthdate: *
1. Why do you want to participate in the program? *
2. Please describe your experience with personal and familial trauma. *
3. Are you willing to commit to participating in this program for six months and attend at least 80% of the sessions? *
4. What are some other programs you have participated in that are trauma related? *
5. Do you have a regular meditation practice? *
6. Describe any triggers, challenges, or habitual pattern that you feel keep you from growing, healing, and integrating, traumatic events from the past? *
7. Are you willing to keep confidentiality about who is in and what is said in our closed group? *
8. What do you need to feel safe in a group setting? *
9. Are you currently working with a therapist? *
10. Do you have any questions or have anything else you would like to share with us? *
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