Trauma-Informed Mental Health Coaching

Registration Form

Early Registration: July 31, 2026

Final Registration: September 6, 2026

Do you identify as any of the following? (check all that apply)

Please share any other important ways you identify.

Embodywise is dedicated to fostering a diverse, equitable, and inclusive learning environment. Please explore our commitments to DEI on our website.

Contact Information

Address

Address *

City *

State / Province / Region *

Country *

Postal code *

Professional Information

What is your current profession? *

Linkedin Profile Link *

Education Degrees (include dates and institutions) *

Briefly describe the extent of your coaching experience, including length of practice and clientele you work with. *

Share any other trauma trainings you've taken or other related educational experiences. Also, please provide anything about your trauma history that you feel comfortable disclosing to us so that we can get to know you. This information is kept strictly confidential.

Do you have any Hakomi designations? (select all that apply) *

What is your prior experience with Hakomi? (check all that apply) *Students must have either completed Level 1 of Professional Skills or Comprehensive trainings, or completed the Hakomi-Informed Somatic Coaching program.

Are there any additional Hakomi experiences not listed above? Please provide Hakomi teachers and trainers you've studied with.

Share any other work history not listed above.

Learning Goals and Needs

Why do you want to take this training, and how will you use it in your work? Please note any special populations you work with. *

Is there anything you would like us to know about how we can make your learning experience most beneficial? Do you have any special needs we can accommodate? *

Are you able to make all the training dates listed? If not, please list dates and times you will be absent. *

Scholarship Form

We are committed to making our training available to underrepresented groups such as People of the Global Majority, LGBTQIA+, military service members, veterans, first responders, persons with disabilities, and those experiencing economic marginalization.

As a nonprofit, we have a limited amount of scholarships available. We respectfully ask for your transparency in completing the scholarship questions. Our goal is to make our programs as accessible and equitable as possible while stewarding the financial health of our organization. Scholarship amounts are based on the regular registration price, not the early registration price.

Are you experiencing financial hardship?

Please select all of the following that apply to your current financial situation.

Please provide any more context on your selections above that would be helpful for us to know.

Do you primarily serve historical underserved or disadvantaged populations?

Please select all of the following populations that you primarily serve.

Please provide any more context on your selections above that would be helpful for us to know.

Please provide the approximate number of clients you serve each year. This will help us communicate the impact of our programs and scholarships to donors.

Please share any other extenuating circumstances we should be aware of.

Please share what tuition amount you are able to pay, keeping in mind that payment plans are available.

Full tuition is $1495. The maximum scholarship amount available for those in greatest need is $495.

Registration Deposit and Acknowledgments

An invoice for your remaining tuition will be emailed to you after your registration is confirmed and processed. Tuition must be paid in full 14 days prior to the start of the training.

Please select the item below. *

Trauma-Informed Mental Health Coaching: Deposit

This deposit must be paid to complete your registration. If for any reason, you do not meet the prerequisites for this program, it will be refunded to you in full.

$400

Please acknowledge the following statement:

I confirm that I have reviewed the cancellation policy and liability waver for this live event and hereby consent to its terms.