The Conscious Circle: Small Group Session Application

There is so much to learn when we come together, soul to soul and embark on a healing journey together... especially when it is an amazingly courageous woman like yourself. If you are open to sharing your heart, getting vulnerable in a comfort-filled, safe circle, then I welcome you to submit an application to join one of my Conscious Circles.
The Conscious Circle is a small group, with six or less women, who come together to explore conscious parenting as a team, in full support of one another's healing. We laugh, we cry & we heal together in this six-week session.
Complete the form below if you would like to be considered for our next Conscious Circle.
Your First Name
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Your Last Name
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Your E-mail Address
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Your Phone Number
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Relationship Status:
  • Single
  • In a Relationship
  • Married
  • Divorced
  • Widowed
  • It\\\'s Complicated
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Do you have children? / Are you pregnant?
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What are the Name(s) and Age(s) of your Child(ren)?
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Tell me more about why you want to explore conscious parenting?

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Tell me more about why you are considering The Conscious Circle?

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Select Your Time Zone
  • Eastern (GMT-4)
  • Central (GMT-5)
  • Mountain (GMT-6)
  • Pacific (GMT-7)
  • Other
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Other Time Zone
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When are you available ?

Please check all the time slots that you are free, Mon - Friday / 9 AM to 1 PM ( Please check more than one )
Monday
Morning-Afternoon
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Tuesday
Morning-Afternoon
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Wednesday
Morning-Afternoon
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Thursday
Morning-Afternoon
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Friday
Morning-Afternoon
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Anything else you would like to share:

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