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Healing Reflections Program Application

Please fill out the initial interest form below. We will be in touch to discuss the program and answer questions within 2-3 business days.

We welcome sliding scale donations ($250-$950) to ensure no one is turned away for lack of funds. Participants in our program receive partial or full scholarships based on financial need. Just let us know how much you feel able to contribute. 

Questions? Please don't hesitate to reach out!

The information you give us will be kept confidential, private, and secure. It will not be shared with 3rd parties or anyone outside our organization. However, with your permission, we would like to anonymously use some of the information you provide for the evaluation of our program. The purpose is to improve our program, as well as our understanding of the impact of our program and the challenges faced by the people we serve.


Consent forms will be provided. Participants will be required to sign a form which ensures that the identity of all participants and any information shared in the program will be considered private, held confidential and not be shared outside of the program.

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