Resilience in Roots

Resilience in Roots
A free Group Healing Therapy Program for African, Black, and Caribbean perinatal individuals (pregnancy and postpartum up to 1 years) from all walks of life.

The program theme and focus is "Resilience in Roots: Honoring Strength in Transition"

Please note this is a hybrid program with in-person and online sessions.

4 week program that runs every Thursdays from 10am to 12pm

All participants will get a wellness kit

Space is limited, and based on approval into the program. Health insurance not required to apply. Available to all residence, of Ontario.
Are you applying for your self or making a referral for a client?*

MyselfReferral for a client
Have you received permission to make this referral?*

YesNo
Unfortunately, you must received consent from your client before being able to referral to our program. Please speak to your client and send a referral once you have consent. Please vist our website for other programs and resources.
This program is for African, Black and Caribbean (Black) individuals. What are your roots (your clients roots)?*

African, Black, and/or Carribean (Black)Another race other than African, Black and/or Caribbean (Black)
Unfortunately the program is only avaialbe for indivudals who are African, Black and/or Black Caribbean. Please visit our website for other programs and resources.
The program is now all in-person based on feedback. The program requires participation of all 4 sessions. Are you ( or is your client) able to commit to the 4 weeks. Please note that you may still fill out the application, but this will be taken into consideration for approval into the program.*

YesNo

Referring specialist name:

First NameLast Name
Referring Specialist number
Please enter a valid phone number.
What is your profssional specialty*

Registered MidwifeDoctor or PhysicianSocial WorkerMental Health TherapistDoulaOther

Participants Informaiton
Please complete the information for the person who will be applying to the program.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Email*
example@example.com
How did you hear about this program*

Resilience in Roots - Registration
Resilience in Roots - Registration*
Categories:All

All

Session 1: May 29, 2025 to June 19, 2025

Session 2: July 1, 2025 to August 3, 2025

Session 3: Oct 3, 2025 to October 23, 2025
prevnext( X )
Session 1: May 29, 2025 to June 19, 2025

Resilience in Roots - Session 14-Week Group Healing Therapy Program for African, Black, and Caribbean perinatal individuals from all walks of life.
$ FreeCAD Register



Session 2: July 1, 2025 to August 3, 2025

Resilience in Roots - Session 24-Week Group Healing Therapy Program for African, Black, and Caribbean perinatal individuals from all walks of life.
$ FreeCAD Quantity



Session 3: Oct 3, 2025 to October 23, 2025

Resilience in Roots - Session 34-Week Group Healing Therapy Program for African, Black, and Caribbean perinatal individuals from all walks of life.
$ FreeCAD Quantity
Do you have any food allergies or sensitivities?*

YesNo
Please list

Confirmation of application
Please note that this form contains Personal Health Information (PHI). By submitting this form, you are consenting to submit PHI to BREATHE Midwives to use for the purpose of providing access to care, our programs, or a referral. You also consent to submitting your information to BREATHE Midwives, in which we may need to contact you.
Please verify that you are human*
Should be Empty: