Group Somatic Therapy 12 week program
We are excited about your interest in joining our women’s circle & group somatic therapy for South Asian Women. This 12 week program is dedicated to improving mental health, relationships, and overall wellness, all while honouring and respecting cultural values. Reason for Screening Application: We know applications can feel daunting, but as we are working to ensure a cohort of motivated and committed individuals to this process of healing individually & collectively it's important to me, Jaspreet Randhawa, that everyone completes an application to ensure that there is a mutual understanding of group expectations and norms, as well as evidence of readiness and willingness to participate and take care throughout the program's entirety. ___________________________________________ Application Closes: 14th October 2024. Program Start Date: 21st October 2024 8pm, continuing for 12 weeks each Monday for 60 minutes. _____________________________________________Acceptance: Applications will be screened and accepted on a first-come first-serve basis. We will notify you by email on the status of your application with next step information including payment.
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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-
Area Code
Phone Number
Age
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Gender Identity
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Time zone
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What other identities are you bringing with you to the program (cultural, ethnic, racial, etc)?
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Why do you feel you’ve ready to join this group therapy program now?
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The “work” can be painful, complicated, difficult, overwhelming, and more! What systems of support do you have in place while you are in this program?
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Somatic therapy requires engagement by you in & out of sessions. Are you prepared to dedicate sometime each day for a small number of gentle somatic practices?
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Please Select
Yes
No
While Jaspreet is a therapist, this is not 1:1 therapy in which it would be appropriate to unpack every individual concern you may have. Nor is this community program meant to serve as a replacement for 1:1 therapy, medical, clinical, or professional care. It is important to recognise when you may require further assistance in a more personal environment. Please confirm you understand this.
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Yes
No
Have you given thought to a presenting issue/growth area that you would like to work on in the group?
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Yes
I’m starting to
Not yet
Can you help
What are some, if any, barriers to you being present, engaged, or motivated in the program?
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What, if any, concerns do you have about this program or being in a group setting?
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Select your payment preference
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£660 Pay in Full
£220 monthly installments x3
I hereby release The Whole Body Therapist, its affiliated and related companies, its principals, directors, officers, agents, employees, contractors, and assigns from any and all injuries, damages, claims, causes of action, liabilities, losses, treatment costs, penalties, assessments, judgments, awards or costs, arising from my participation in the Group Somatic Therapy for South Asian Women 12 week program. *I hereby indemnify and agree to defend and hold harmless Whole Body Therapist, its affiliated and related companies, its principals, directors, officers, agents, employees, contractors, and assigns from and against all demands, claims, actions, proceedings, damages, liabilities, losses, fees, costs or expenses, including reasonable attorney’s fees and costs, arising out of, resulting from, or relating to my participation in the Group Somatic Therapy for South Asian Women 12 week program
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