The Inner Healer Application - New Human Events

Level One — Program Application

ACTIVATING THE INNER HEALER

Thank you for your interest in Activating the Inner Healer. This 10-week experience is designed to help you build a stronger foundation, deepen your relationship with your body, and develop greater capability in supporting your own wellbeing.

This application is simply an opportunity for me to get to know you a little better — where you are right now, what you’re navigating, what is calling you forward, and whether this experience feels like the right fit. There are no perfect answers. Please share openly and in whatever way feels true for you.

First Name

Last Name

Where do you live? Please include city, province/state and country.

What called you to this program at this point in your life?

YOUR HEALTH & WELLBEING

Are there any diagnosed health conditions you are currently navigating?

Are there any symptoms, health concerns, or undiagnosed issues that you would particularly like to improve or better understand?

How would you describe your current health and vitality on a scale of 1–10?

What have you already tried to support your health?

If you could experience a meaningful shift over these 10 weeks, what would you most love to feel different in your body or your life?

READINESS & INTENTION

What would make these 10 weeks feel truly meaningful or valuable to you?

Is there anything in your life, schedule, or current circumstances that could make it difficult for you to engage with the program over the full 10 weeks?

This work is not designed as a quick fix. It is a paced, educational and relational process that asks you to participate, pay attention, and build a deeper relationship with your body. How does that approach resonate with you?

Is there anything else you'd like me to know about you as a person, or about what you're bringing into this experience?

A FINAL NOTE

Thank you for taking the time to share about yourself. I will read each application with care.

* All responses are kept private and confidential.

Activating the Inner Healer is an educational wellness program and is not a substitute for medical diagnosis or treatment. Participants should continue appropriate medical care and consult qualified health professionals regarding medical conditions, medications, pregnancy, or significant changes to their health routine.

Level One — Program Application

ACTIVATING THE INNER HEALER

YOUR HEALTH & WELLBEING

READINESS & INTENTION

A FINAL NOTE

ACTIVATING THE INNER HEALER

Level One — Program Application

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