APPLICATION FOR ARTEMISIA

Fill out the form below and we will be in touch to discuss admissions for our April 2022 intake.

Name

First Name

Last Name

Timezone/Location

Phone number

Why do you desire to be a leader in integrated practice?

What has inspired you to deepen your knowledge of energetics?

Please list previous modalities/therapies you have had experience with.

Includes any qualifications you hold from any field.

Have you attended any energetics trainings or courses previously? If so, please name them.

Please list any past or current health (physical or mental) issues that may be relevant.

(Specify if resolved or current. )

Do you have a history of recreational drug and alcohol use? And how is that relationship currently?

If we decide this programme is a good fit for you, a deposit of $500 will be required. Are you willing to invest this to start the process?

Please choose from the following

Any questions about the training you may have:

Did you speak to anyone that guided you to this form?

Instagram Handle

We'd love to stay connected!