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Internal Intensive Application Form

30-min intro call with a member of our clinical team to decide if an intensive is best for you

ask some of intake questions for intensives, tell them what an intensive is (trauma informed, narrative driven, no active addiction, be able to name, this is the 1 thing I’m coming to work on)

A therapeutic intensive with Sage Hill is designed and uniquely tailored to the client to help gain clarity, get unstuck, and gain momentum. Typically, intensives are 2.5–4 days long, depending on the needs of the client. Costs: Minimum of 3 days, $1,500 a day, 3 or 4 days = $4,500 or $6,000. If approved, $500 deposit

Briefly describe what you hope to gain from participating in the therapeutic workshop.

Are you currently engaged in counseling? If so, please describe the work you are doing.

Have you ever been diagnosed by a mental health professional? If so, when was this and what was your diagnosis?

Have you ever been in treatment for or hospitalized because of issues related to addiction, emotional distress or psychological trauma? If so, please describe the circumstances and outcome.

Have you ever been addicted to any mood altering substance (illicit drugs, prescription medication, alcohol, nicotine) or behavior (sex/porn, gambling, eating disorder, etc). Active addiction? If so, please describe.

Are you on any psychotropic medications (including medications for anxiety and/or depression)? If so, please list which ones and your prescribed dosage?

Do you have any history of sexual trauma? Please describe.

What’s your time frame for the intensive?

Couple specific: Has there been any infidelity or trial separations?