Healers Event Registration

******Please register by November 19th! *****

Healers & Helpers: A Therapy Speed Meeting Event
Date: Sunday, November 21st, 2021
Time: 12PM-3 PM
Location: Virtually (Zoom & Calendly) - Details sent after registration

Definitions:
What are Healers (participants)? We believe that everyone holds the capacity to heal themselves, but sometimes we need help. A Healer in this context refers to someone seeking support from a therapists, psychologists, psychiatrists, marriage and family counselors, doulas, life coaches, alternative/natural/holistic healers, sex therapists, herbalists, spiritual/pastoral care counselors, doulas, midwives or therapeutic aestheticians. We are seeking Black folks of marginalized gender experience, specifically women (trans* and cis), femmes, and other gender expansive folx for this event.

What are Helpers (practitioners)? We consider Helpers to be anyone who is trained to respond to trauma, crisis, or the life management of others within the Healing Justice Framework. This may include but is not limited to therapists, psychologists, psychiatrists, marriage and family counselors, doulas, life coaches, natural/holistic healers, sex therapists, herbalists, spiritual/pastoral care counselors, doulas, midwives or therapeutic aestheticians. These practitioners must also be Black folks of marginalized gender experience, specifically women (trans* and cis), femmes, and other gender expansive folx and currently taking clients.

Notes:
Please understand that this event is not an actual therapy session; it is an opportunity to connect with a Helper from whom you would like to seek support/therapy.

If you are unable to register online, have questions, or need additional accommodations, please call or text 267-606-0992.
You can also reach us by email: WomanistWorkingCollective@gmail.com

Please answer carefully and to the best of your ability.
Sign in to Google to save your progress. Learn more
Email *
Name *
Phone Number *
Do you self-identify as Black or part of the African Diaspora ? *
Everyone must answer.
Do you identify as a marginalized gender experience, specifically women (trans* and cis), femmes or other gender expansive person? *
If you don't see an option listed that best describes your gender identity, contact us and we'll add it to the list: (267)606-0992
How will you compensate your Helper or Healer (at future sessions, not at this networking event)? *
Participants must answer.
If you plan to pay this Helper through your insurance, please share the name of your insurance carrier. This will help us to invite someone who may take your insurance.
What kind of support are you seeking?
Healers must answer.
For Healers: In which specialty areas would you like your Helper to have experience? For Helpers: Please select all with which you have experience. *
Everyone must answer.
Required
We're using Calendly to schedule video chats with the Helpers, do you think you'll need assistance with these platforms?
If you check the button "yes", we'll reach out
Clear selection
What did we miss? Need help using Calendly? Include your notes and additional accommodations below. You can also call us to discuss additional accommodations: 267-606-0992
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy