Application for the Somatic Awakening® Immersion Program (SAIP)

The questionnaire below is designed to provide us with valuable information, which will be useful in our work together. It will also help determine if SAIP is appropriate for you at this time. This information will be held confidential and will only be used in the application process. Please answer ALL questions below clearly and honestly. However, there is no need to answer them perfectly. We want to get to know the true you.

Once you complete the application, you will need to schedule an application call. After you submit this application you will be redirected to a page with more information on how to schedule that call.

Also, please note that there is a prerequisite course for this program. Any of the following are considered prerequisites:

The intensive The Homecoming,
Online class Embody Healing and Freedom (which is also a free bonus connected to this course),
The previously offered online course The Quantum You.

*Note: if you have not attended The Homecoming nor have completed Embody Healing and Freedom (EHF), you will need to complete the first two modules of EHF before the first retreat.

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Name*

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Today's Date

Email*

Date of Birth

Home Phone

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1) How did you hear about, and please describe any previous involvement, with Somatic Awakening® and/or Sophia Healing Academy? Have you already taken the prerequisite course Embody Healing and Freedom?

2) What draws you to Somatic Awakening®, and why is this program calling you at this time on any level - somatically, emotionally, spiritually, energetically, etc.? Also, please elucidate your level of commitment in regard to joining this program?

3) Are you interested in attending the Somatic Awakening® Immersion Program for your personal healing and awakening, are you interested in becoming a Somatic Awakening Practitioner, or are you undecided at this time? Feel free to go into detail as desired.

4) Please briefly describe any major events, significant trauma, or abuse that you have been through in your life. What ways do you feel these past experiences are still affecting your life and are you wanting to bring awareness and healing to them within this program?

5) Are you prepared to invest in this program, financially and timewise? Is there anything you sense that might stand in the way of you completing this program?*

6) What kinds of psychological/mind-body therapies are you, or have you been, involved with in the past? Are you already a practicing healer? If so, please describe.*

7) Is it relatively easy or difficult for you to meditate? Also, please describe your life as a spiritual practitioner and any significant experiences.*

8) Is it relatively easy for you to connect to your intuition, emotions, energy, and in general make contact with your inner reality? Or, is this difficult for you? Please explain.*

9) Have you ever been diagnosed with (or thought you may have) a mental illness, an addiction to alcohol or drugs, or had suicidal tendencies/ideation? If so, please describe and elucidate if these issues are still actively present in your life now?*

10) Are you currently taking any medications connected to emotional issues or pain, such as anti-depressants, anti-anxiety medication, benzodiazepines, opioids, etc.? If so, please describe.*

11) Is there anything else you sense is important for us to know about regarding this program and your life?*

12) Where did you hear about the Somatic Awakening® Practitioner Program, and if you attended the the three day intensive The Homecoming who or where did you hear about that class from?*

Thank you for completing this application. After you submit this application you will be redirected to a page with information on how to schedule your application call.

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