RESET Breathwork™ Teacher
Training Application

Welcome! We’re so glad you’re here. Take a deep breath in and arrive in your body and your purpose.

Answer each question with your biggest visions in mind for this Teacher Training (and beyond!).

Think of this as us meeting you for the first time, so that we can understand why this training is a YES for you and your mission and why you should be chosen.

This program is selective and intentional, and we’ll review each and every application with care and full consideration. Once you submit your application, you will be directed to book a connection call with us (Dr. Cory & Jess).

If you're invited on the call or after, you will then have 3 business days to claim your spot and make your first payment or pay in full, otherwise your spot will be released.

First Name *

Last Name *

Email *

Phone *

Address

Street Address

City

State

Country

Postal code

Please list your most up-to-date shipping address + any additional info, if it's not the same as the address listed above as items will be shipped to this location. Otherwise, list N/A. *

Your full name as you would like it printed on your certificate of completion *

What is your time zone? *

What is your Instagram handle or website? *

Level of experience w/ Breathwork? *

Newbie (Never done Breathwork before!)

Beginner (I've tried it a few times)

Intermediate (I'm ready for more!)

Advanced (It's my jam!)

If you selected "other," please specify and/or list the person who referred you, so we can thank them! *

Have you taken training in any other healing modality? If so, what modalities? *

How has Breathwork impacted your life? *

What is your deepest WHY and intention for applying for this training & certification? What goals/desires have been manifesting in your heart? *

When you zoom out of that vision, is there anything holding you back? Where do you get to go next in your evolution of leadership? *

How do you see this Breathwork Training impacting your business and/or community? *

Why do you want to train specifically with Dr. Cory & Jessica? *

Are you able to attend both weekend intensives (online) on March 7 & 8 and May 16 & 17 at 10am-5pm PST each day? *Important: Attendance is MANDATORY. *

YES, absolutely!

It would be a stretch

No

On a scale of 1-10, how motivated and committed are you to going all in on the work inside this training, in order to become a master facilitator? *

I understand that this is a highly respected certification program and that there are strict requirements I must complete in order to receive my certification. I have read all the details on the website, am clear on the requirements and pricing (listed under 'Your Investment' section), and I am ready to commit to this training. *

Yes, I understand & I'm ready!

Yes, I understand & just have a question(s) I'd like answered first

Training with us is a high level experience. We understand that investing in yourself can be scary (we've been there!), but we only work with individuals who are ready to level up their life/career in a massive way. Please describe how you would like to pay your tuition. *

I'm ready and able to pay in full

I'm ready and will need a 4 month payment plan

I'm ready and will need a 8 month payment plan

Your last step is to book a 30-minute Connection Call with Dr. Cory & Jessica to ensure Breathwork Teacher Training is the best fit for you at this time. Please select a date and time below.

Is there anything else you feel like we should know? Or a question we can answer for you?

By checking this box, I agree to receive recurring marketing and promotional text messages (e.g., special offers, updates, discounts) from The Healing Couple. Message frequency varies. Msg & data rates may apply. Reply HELP for help, STOP to cancel.

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RESET Breathwork™ Teacher Training Application

Take a deep breath and submit 🙏

RESET Breathwork™ Teacher
Training Application