Healing & Alternative Healing Recovery Programs Application

( Radiant Recovery Program - Scholarships - Sliding Scale - Program Interest )

This application helps us understand how to best support your healing and recovery. You may apply for one or more programs, including Radiant Recovery, scholarship support, or sliding scale options.There are no right or wrong answers, and you are not required to share anything you are uncomfortable disclosing.

(You do not need to be clean and sober to apply for support. We love and support you no matter where you are on your recovery journey. You do not have to face your healing alone.)

First name

Last name

Preferred name?

Phone

Email

Preferred method of contact?

Phone call

Text message

Email

Which programs are you interested in? Select all that apply.

Radiant recovery - 12 week VIP alternative recovery program that heals the root cause of your behaviors, leading to real and lasting change.

In-Home Retreats - Personalized to your groups needs.

Individual healing services. (Root cause therapy, breath work, astrology & tarot coaching, soul alignment readings)

Group healing services. (yoga, breath, work, therapeutic art, energy healing, Reiki certifications, DBT groups)

I'm not sure what would be best, I'd like to discuss my options with a healer.

Anything else you would like to see?

How would you like to access services?

Full scholarship consideration

Sliding scale/reduced cost

Self-pay

Not sure yet, let me know what I qualify for

If requesting scholarship or sliding scale, please share anything you would like us to consider. You may include financial hardship, recovery, status, housing, instability, or other factors you feel are relevant.

Are you currently connected to any recovery, medical, support services? If not, do you need resources?

What is your commitment to healing? 1 being not very committed and 10 being extremely committed?

What are you hoping to gain from healing or recovery support right now? (examples: emotional stability, relapse prevention, coping, tools, community, self understanding, etc..)

Please acknowledge the following:

I understand that healing services do not replace medical or emergency care.

I understand that submitting this application does not guarantee placement or funding.

I consent to being contacted regarding this application.

I can send to my healer communicating with the recovery house in which I live.

I understand if I am accepted into the 12 week program I am committing to 12 appointments in a row on the same day and time each week. If I do not show up, I forfeit that appointment. If I no-show to three in a row, I will be removed from the program.

I understand that alternative healing programs do not replace my therapist, my IOP, or my primary care doctor. I commit to continuing with all of my appointments during the 12 week program.

A Safe Space to Heal, Grow, and Begin Again

Holistic healing, trauma-informed support, and transformative recovery — for every stage of the journey.

Healing & Alternative Healing Recovery Programs Application