Apply to work with me Please share your responses and submit below. Name * First Name Last Name Email * Phone (###) ### #### How did you hear about Creatively? Instagram Tiktok Youtube Recommendation Therapy Other (please indicate below) What are your pronouns? They/them She/her He/him Other Select State of Residence Outside the U.S. Option 2 What is your biggest mental health challenge that has led you to apply to work with me * What are you experiencing on a regular basis in connection to this challenge What is the duration of time you have been experiencing stress related to this challenge? Do you have thoughts of self-harm or not wanting to be alive * Yes NO Tell us a bit about your Mental Health History (i.e. trauma, orientation, diagnoses, etc. ) Have you been in therapy before? What kind? Where do you feel like there was a gap in these methods? What didn't work? How are you hoping I can help you? What do you feel are some of your strengths? What are some of your "growing edges" ( weaknesses or things you would like to strengthen in yourself.) How ready are you at this time to commit your time, money, and energy to work on this? I am energized and motivated to take the steps to transform my life from zero to hero. I am not quite ready to commit fully to working on this. I have hesitations to making a long lasting change The investment for the program is $150 USD per week for 8 weeks. (If you knew that this work would make a difference in yourself, would you be willing, ready, and able to invest that at this time? Yes! I am absolutely ready and able to invest that in getting support. I want to get started ASAP! It's important to me to invest and I am able to invest in that price range, but I have some questions and hesitations before I commit. I am not in a place financially to invest in support and I can't find a way to make it work at this time. Please send me free and low cost resources for now. If we believe our program is a good fit for you, are you ready to enroll at this time and get support? Yes! I need to catalyze my life and actualize my dreams! No. I am not ready at this time Add us on Social Media! ig @dance.movement.therapy Thank you for Applying! We will get back to you soon.
