You can always press Enter⏎ to continue
Abbreviated Communities of Color IFS Healing Circle Discovery Questionnaire
Ready to embark on a journey with me?
Start
1
First off, what's your email address?
*
This field is required.
example@example.com
Previous
Next
Submit
Press
Enter
2
Great, and what's your name?
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
3
Do you identify as the global majority
Yes
No
Previous
Next
Submit
Press
Enter
4
What motivates you to join this offering?
*
This field is required.
Previous
Next
Submit
Press
Enter
5
What feels important for you to share about yourself?
*
This field is required.
Previous
Next
Submit
Press
Enter
6
What are your preferred pronouns?
*
This field is required.
Previous
Next
Submit
Press
Enter
7
What are you hoping to get out of this offering?
*
This field is required.
Previous
Next
Submit
Press
Enter
8
Do Mondays, 1:00 - 2:30pm ET work for you?
*
This field is required.
Subsequent meeting dates, every Mondays at 1:00-2:30pm ET starting June 8th, 2026
Yes
No
Previous
Next
Submit
Press
Enter
9
You Investment
$50 for the full 4-week healing circle. Payment is required to secure your spot. Due to the limited and intimate nature of this group, all payments are non-refundable once the group begins.
Agree
Do not agree
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
9
See All
Go Back
Submit