Virtual Support Chat and Retreat Application

This application is for virtual support chats OR for a retreat. If you are not applying for a retreat, please skip to the questions below.

Western Mass Equine Therapy (WMET) is a Post Acute Holistic Trauma Center located in Conway, Massachusetts. This area offers a very pure natural setting in a community that is rich in holistic healing opportunities. You are welcome to come here to rest, decompress & integrate the trauma you have experienced on your immigration journey.

Retreats are for asylum seekers & new immigrants who have been in the US less than 3 years.

Closest airport is in Bradley International in Hartford, CT. We are 45 min north. You can take a shuttle or bus from the airport to this location.

WMET provides a peaceful setting for you (& your children) that can include walks in nature, art & music therapy, equine therapy for mental health, pet therapy, yoga, qigong, meditation, group or private Phoenix Rising Yoga Therapy & life coaching.

We will provide a list of affordable & peaceful housing options in our community where you & your immediate family can stay. If your sponsor is able to watch your children, attending alone may be the most restful & affordable option. Children are also encouraged to attend to transform the trauma they have experienced on their immigration journey,

is not an acute trauma treatment center. Please consult your medical doctor & therapist for acute trauma treatment before applying.

Families, please fill out an application for each family member who is requesting holistic post acute trauma support.

Are you applying for:

Trauma Support Retreat

Support Chats

Both

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Email

Country of Origin

Age

How many months or years have you been in the United States?

Gender

Asylum Seeker Number

Sponsor Name & Contact Information

Please give as much information as possible such as address, email, and phone number(s) of your sponsor.

Check this box if you are not sponsored

I'm not sponsored at this time

Trauma Diagnosis

Acute Trauma Treatment Received & Date Received

Medications currently taking for mental health & other coping strategies:

Emergency Contact Information

Please give as much information as possible (name, address, email, phone number)

Please describe briefly why you want to receive holistic trauma support

Preferred Dates for your stay

A maximum of 10 days. We are closed Nov 1st - April 1st.

The information I've provided on the application is true.

Yes

No

Signature (type /s/ and then your name):