Scratchy GIRL Application Somatic Therapist Consultant Form

Application Form – Somatic Therapist (Sensory Touch Healing)

Thank you for your interest in joining Scratchygirl.com, where we provide holistic, body-based healing experiences through sensory touch and somatic therapy. Please complete the application below with honesty and thoughtfulness.

Please click NEXT in the bottom right of your screen to proceed with the application. Thanks!

Basic Information

Full Name *

Preferred Name (if different)

Pronouns *

She/Her

He/Him

They/Them

Email *

Phone *

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Address

Street Address *

City *

State *

Country *

Postal Code *

Professional Background

Are you currently certified or licensed in any body-based or therapeutic modalities? *

Yes

If yes, please list your certifications/licenses (including dates and issuing organizations):

How many years of experience do you have in somatic or touch-based therapy? *

Less than 1 year

1–3 years

3–5 years

5+ years

Describe your training or background in somatic therapy, sensory touch, or related fields: (Feel free to include formal education, workshops, apprenticeships, etc.) *

Describe your therapeutic approach and philosophy around sensory touch and healing: *

What do you believe is most important in creating a safe and transformative experience for clients? *

Availability & Logistics:

We are open Tues - Fri 2 - 7 pm Saturday 11 am - 7 pm

Are you available to provide in-person sessions on weekends and evenings? Or weekdays. *

What days/times are you typically available for sessions? *

Do you have access to a private practice space or studio? *

Yes

Working on it

Ethics & Boundaries

Have you ever had a complaint or disciplinary action related to your professional practice? *

Yes (please explain below)

If yes, please explain the complaint or disciplinary action related to your professional practice:

How do you maintain clear and healthy boundaries in touch-based healing work? *

Final Thoughts

Why do you want to work with Scratchygirl.com? *

Is there anything else you’d like us to know about you, your story, or your work? *

Attachments

Please upload the following documents with your application (if applicable):

Resume or CV
Copy of relevant certifications
Links to your professional website, social media, or portfolio (if available)

File Upload *

Signature

I certify that the information provided in this application is true and complete to the best of my knowledge.

Signature *

Clear

Date *