Realign & Reclaim Reset with Dr Cass Tan – Application Form

Welcome, beautiful soul 🌿

I’m so honoured you’re feeling the pull to work together in this intimate reset journey. This form helps me understand where you’re at and how I can best support you.

You’re applying for 1 of 12 exclusive spots in the Realign & Reclaim Reset — a 6-week private recalibration experience designed to help individuals shift emotional blocks, reset their nervous system, and reconnect with clarity, calm, and embodied alignment.

Once submitted, I’ll personally review your application and send you a welcome message with payment and booking details within 24 hours.

All responses are confidential. You’ll be contacted via email or DM.

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Full Name *
Email Address *
Mobile Number (for WhatsApp connection) *
Please include your country code (e.g. +61 for Australia)
Instagram Handle (Optional)
What are you currently feeling stuck with or needing support on? *
Have you worked with me before? *
How ready are you to commit to this journey? *
How would you like to pay? *
Anything else you'd like me to know?
Before You Submit

A quick note from me, Dr Cass.

I’m a Doctor of Chiropractic with years of experience supporting individuals physically, emotionally, and energetically through mind-body work, nervous system regulation, and embodiment-based tools.

Please know that while I bring clinical experience and holistic insight, I am not a psychologist, psychiatrist, or mental health crisis professional. I do not diagnose or treat mental illness.

What I offer in this reset journey is based on proven techniques and insights that have helped both myself and my clients feel clearer, calmer, more connected, and empowered in their lives.

I ask that you enter this journey with self-responsibility and self-awareness. I will walk with you — but I cannot walk for you.

I do not support unsafe, misdirected, or manipulative practices, and I am committed to maintaining a safe, grounded, and ethical space throughout our time together.

Thank you for being open, honest, and sovereign in this process 🌀

Do you acknowledge and agree to the above? *
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