Page 1 of 1
Live a Life You'll Love to Death
Name
*
Email address
*
Which path are you applying for?
*
A
Path to Living Well (16-weeks)
B
Guided Self-Mentorship (4 Week Intensive)
C
Plant-Supported Path (Supplement + 16-weeks)
Where are you located?
*
Do you prefer online or in-person sessions?
*
A
Online
B
In-person
What's bringing you to ask for support? What makes now the moment?
*
What are you hoping to gain from this work? If 16-weeks from now, you were living a life you love to death, what would be different?
How committed are you to completing all sessions, surveys, and between session work?
*
1
2
3
4
5
6
7
8
9
10
Not really committed
Neutral
Very committed
Disclaimer
*
I understand that applying for this form is not applying for therapy, counseling, crisis support, or medical treatment.
Apply!