Program Application

Take the first step toward deep, neurophysiological healing.

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Personal Information

First Name

Last Name

Email Address

Phone Number

Which program are you applying for?

Client Program

For individuals seeking deep trauma resolution and nervous system regulation.

Professional Training

For clinicians looking to integrate neurophysiological modalities into their practice.

Healing Intensive

Concentrated, multi-day deep dives for rapid processing and integration.

Brief overview of your therapeutic journey (Optional)

Have you worked with EMDR, Somatic Experiencing, or Polyvagal approaches before?

What are your primary intentions for this program?

What shifts are you hoping to experience in your nervous system and life?

Thank you for taking this courageous step. We will review your application and reach out to you within 48 hours.