Art of Intimacy Application
New York City 2019 - 2020

Level I

In Person Dates:

October 4-6th, Nov 22 -24, 2019

Jan 24-26, Mar 14-16, 2020

*Interview Required For Admittance*

To apply for the course, please fill out application below and we'll be in touch to schedule a call for you with Lynn Kreaden

Name *

Name

First Name

Last Name

Email Address *

Phone *

Phone

Country

(###)

###

####

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birthday *

Birthday

MM

DD

YYYY

Gender *

What practices, trainings or workshops have you done in the areas of self transformation, personal development, meditation, movement, spirituality and somatic therapy. Please describe. *

Have you been in any type of Psychotherapy? If so, when and how long? Are you in therapy at his time? *

Are you currently taking medication? If so, which medication and dosage? *

Do you have a history of mental illness? If so, when and what has been your treatment? Did it include hospitalization? *

Do you have a physical impediment your participation in the program? *

Do you have a history of sexual abuse and/or trauma? *

Do you have a history of any type of addiction? If so, please describe *

How did you hear about The Art of Intimacy Program? *

Anything else you would like to share about yourself that would be pertinent to participating in the Program?

Questions? Email Lynn at lynn@lynnkreaden.com or Kathryn at kathryn.piper03@gmail.com

Art of Intimacy ApplicationNew York City 2019 - 2020

Art of Intimacy Application
New York City 2019 - 2020