Application for The Sustainable Behavioral Health Provider Intensive

Application for The Sustainable Behavioral Health Provider Intensive

Complete this form to apply for the 8-week coaching program and share your background and intentions.
Applicant Information
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
State of Residence
License Type
License Status
Years of Post-Graduate Experience
Current Work Setting
Eligibility and Financial Readiness
Have you reviewed the eligibility requirements?
Regarding financial decisions for this type of investment, which best describes your situation?

Other
The Individual Intensive is a significant financial investment. Without disclosing the specific amount here, are you prepared to make a meaningful financial commitment to this work if it feels like the right fit?
Thank you for your honesty. The Individual Intensive may not be the right fit right now — and that is okay. If you would like to discuss further or explore a more accessible starting point, our consulting services offer one-time engagements that may be a better match for where you are right now. We would love to still support you. Visit https://www.beyouthentic.com/consulting to submit a consulting inquiry.
Application Details
What is bringing you to the Intensive right now?
What does your current level of burnout or strain feel like?
What would a successful outcome look like for you?
Preferred format
How did you hear about YOU-thentic Elevation?
Should be Empty: