The Private Container — application

Tell me about you

A short questionnaire — no pressure. If you are interested, it's worth starting the conversation. Let May know what's bringing you here, and what you are hoping from this container.

Your name

Phone

What's been happening

What are you struggling with lately? What has been happening inside you and in your life?

What you'd like to change

What would you like to be different in your life? What are you hoping this will help you move towards?

Suitability to the Container

How did you learn about this container? How do you know this container will help you? Which part of the container appeals to you the most?

Readiness & background

What is your stress level (1 is relaxed and 10 is very stressed). How is your sleep, substance use and screentime these days? Have you done therapy, counselling, or other healing work before?

We will contact you to continue the conversation. If you're currently in crisis, please reach out to 9-8-8 or 9-1-1 (Canada) right away — this form isn't monitored for urgent support.