Bear Root Resource Center General Intake Questionnaire Logo
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  • Our Collective Bright Future

    Empowering Our Community With Prayerful Intentions. Bear Root Resource Center aims to S.H.I.F.T. the narrative to Support, Heal, Inspire, Fulfill, and Transform individual lives and communities in all 4 directions. 

  • Our Priorities

    We are uniting people to overcome and thrive in response to the local and global impacts of climate change and broken systems that perpetuate harm in our most vulnerable communities. We teach people to be in relationship with the land and connect to their roots.

  • Welcome

    Let's get started and get familiar with what to expect.

  • Welcome to Bear Root Resource Center! We strive to offer an inclusive safe space to connect and collaborate with our local and global community, to share our events, workshops, and virtual experiences with you.  We offer a unique experience that welcomes everyone of all backgrounds and want an opportunity for folks to relate to each individuals lived experience through their personal roots.  We are revolutionizing how current systems relate to a person's identity, and rather than over generalizing into a broad cateogory, we want to truly capture all that relates to a person's cultural identity and ethnic background.  You may be interested to know that the root of each culture is connected to the land they are from, and we apply the Universal Epidemiology as a lens to teach traditional knowledge and support the well-being of our community members as a whole person (Mind, Body, Soul), and use this data to empower our community. We developed programs to enrich lives of individuals from all backgrounds to be able to fulfill their full potential. We offer resources for allies and community partners to learn how to be in right relations with BIPOC communities and implement multi-racial equitable agreements to maintain long-term commitments. 

    We apply Ujima to build and maintain community together through cultural revitalization, restorative justice, regenerative resources for BIPOC multi-racial and Two Spirit LGBTQIA+ communities to thrive. Collaborating with community leaders and creating coalitions to advocate, protect and impact policy to enrich lives of our diverse community. We are guardians for our youth, to nurture stability for our future 7 generations, and we are dedicated to collectively protect all that is sacred in perpetuity, as a legacy to honor the wisdom of our elders, and to those who came before us and made it possible from their efforts.

  • General Intake Form

    We will be asking in-depth questions that have a human centered approach, and look at all ways to offer support in all areas of your life.  We will look at the whole picture from a mind, body, soul, culture, as well as socioeconomic and environment approach.  You may pause and complete questions at your own pace.  If you would like help to complete the form, please e-mail info@BearRootResourceCenter.com or call us at 1-707-235-4963 to schedule an appointment to complete the process together.  We look forward to connecting with you soon. Our Form follows HIPAA compliance standards and is highly secure. Your responses will be strictly confidential and we will be following up with you directly. Please allow for up to at least 1 hour and 30 minutes to complete. **YOU MUST COMPLETE THIS FORM IN ORDER FOR US TO RECEIVE YOUR APPLICATION** If you do not go all the way through to the end of the application and sign the final confirmation, THE APPLICATION WILL NOT BE SENT TO OUR STAFF. We only receive the complete applications. Upon completion, you will receive a confirmation email once your application was successfully submitted and sent to our staff. If you do not receive this email, or if you have any questions, please reach out to our local office via phone or e-mail. If you don't provide a reliable way to contact you, then your application may be delayed or we may not be able to process it. ***DISCLAIMER: Completing this application is not a guarantee that you will receive services. That is dependent upon your eligibility and the availability of program funding.****

  • Privacy Policy

    We included an Emergency Assistance Disclaimer and a Health & Medical Disclaimer

  • Welcome to Bear Root Resource Center Privacy Policy (Summary below, and please view our Privacy Policy Page for more detailed information)

    Bear Root Resource Center [Bear Root Resource Center or "BRRC" AND ITS AFFILIATES (“COMPANY” OR “WE” OR “US”)] This page informs you of our policies regarding the data collection when you accept "cookies" and how we use information.  We may collect and use personal information such as:  name, address, phone number, and email address when it is voluntarily  provided to us.  We may use data to help with our research, advocacy, organizing strategy; to optimize our marketing or digital services and operations; fundraising; legal services; merchandise; and when required by law, to prevent fraud and protect our or others’ rights.  We follow these eight principles when processing your personal  information: Transparency, Individual Participation, Purpose Specification, Data Minimization, Use Limitation, Data Quality and Integrity, Security, and Accountability. 

     
    Terms & Conditions (Summary below, and please view our Terms & Conditions Page for more detailed information)

    Please read these Terms and Conditions ("Terms," "Terms and Conditions") carefully before using the Bear Root Resource Center "Community Platform" https://bearrootresourcecenter.com (the "Website" or the "Service", or "Services" or "Platform") operated by Bear Root Resource Center [Bear Root Resource Center or "BRRC" AND ITS AFFILIATES (“COMPANY” OR “WE” OR “US” or "OUR")]. 

     

    If You Or Someone You Know Needs Emergency Assistance Disclaimer

    Remember, you are not alone. ***If you or someone you care about is experiencing a life threatening emergency, please dial 9-1-1. If you are feeling overwhelmed and would like emotional or mental health resources, please dial 9-8-8, which is a 24 hour/7 day per week hotline throughout the U.S. If you need emergency resources and reside in California, please dial 2-1-1 to be connected to local agencies for further assistance.***

    Health & Medical Disclaimer
    Bear Root Resource Center does not provide medical advice. Bear Root Resource Center Community Platform may include features to promote physical activity and may only provide general information regarding health, nutrition, wellness, and physical exercise through its Service. You acknowledge and agree that the Service is not intended to be, and will not be used as, a substitute for medical treatment by a health care professional. You agree to consult your healthcare provider before initiating any physical exercises or wellness practices, and follow your provider’s advice accordingly. You also acknowledge and agree to accept the inherent risks and dangers in participating in new or strenuous health, wellness, and physical exercises. You agree that Bear Root Resource Center Community Platform will not be liable for any injury, loss, or damages arising from your access or practice of the Service’s health, wellness, and/or physical exercise content.

  • Personal Information

    (All Information That You Agree to Share Is Secure & Private. We ask you to be honest and share as much as you feel comfortable to answer. This helps us to personalize your experience and connect you with resources that match your unique needs. Let us know if you need further assistance to help complete this form and we can set up a time to complete the application with you. We look forward to connecting with you soon.)

  • Click here to Shedule an Appointment to complete this form or to discuss your next steps to get started with your personalized S.H.I.F.T. Program plan options together.

  • Pre-Screening for Emergency Assistance, Language Interpreter Request, or Reasonable Special Ability Needs Accommodation Request

    We flag applications with special circumstances to connect them with appropriate resources. If any of these needs apply to you, please check all that apply. Otherwise, proceed to the "Contact Information" and complete the rest of the application. We look forward to connecting with you soon,

  • Contact Information

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  • Click here to Shedule an Appoointment to complete this form or to discuss your next steps to get started with your personalized S.H.I.F.T. Program plan options together.

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  • Copyright © 2023 S.H.I.F.T. Programs (an Affiliate of Bear Root Resource Center)- All Rights Reserved.

    BEAR ROOT RESOURCE CENTER [AND ITS AFFILIATES (“COMPANY” OR “WE” OR “US” or "OUR")]

    KERI R. AKEMI-HERNANDEZ, FOUNDER &  BENCY JOSEPH, CO-FOUNDER

    2023 © ℗®™  ALL RIGHTS RESERVED.

    BEAR ROOT RESOURCE CENTER, a fiscally sponsored organization of Fiscal Sponsorship Allies EIN: 85-0839183

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