Additional Comments

First Name

Last Name

What is your support request *

Please check all that apply

1 - 1 Grounding Session 30 min

1 - 1 Grounding Session 45 min

Group Virtual Grounding 30 min

Group Virtual Grounding 45 min

Group In-Person Masked Grounding 30 min

Group In-Person Masked Grounding 45 min

Opening Grounding 5-10 min

Something Else?

Do you hold any the below identities? *

please check all that apply

Black

Brown, Indigenous or Person of Color

Disabled - Neurodivergent - Immunocompromised - Chronically Ill

Queer - Nonbinary - Trans - Gender Expansive

Trauma Survivor

Parent of Medically Complex Kiddo

1. What kind of session are you looking for? *

Affirmations

General Relaxation

Grief Support

Quieting your mind

Support with a specific goal or issue

Something else