* Full Name
* Mailing Address
Confirm email Address
Please describe any previous experience you have had with stress reduction, meditation, relaxation, mindfulness, imagery, and other mind-body approaches to healing and health. If you have not had any prior experience, please write “no experience”.
Please describe your reasons for taking this course. What goals or intentions would you like to set for yourself?
What brings you joy?
Are you currently involved in a specific medical treatment or psychological counseling program? If yes, please describe.
Are you currently taking any medications for physical or psychological conditions? If yes, please list each medication and the condition it is being used to treat.
Do you have any history of physical illness or limitations which might be aggravated by or interfere with sitting and walking meditation?
Add any additional comments you would like to convey to the teachers:
A total of 9 CEU’s are available for licensed clinical social workers, marriage and family therapists, mental health counselors, and master social workers at no additional cost.
Sati is an approved CEU provider through the Oregon Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling.
Please register me for CEU's. My Oregon license number is below.
CEU License Type
Oregon Licensed Clinical Social Worker
Oregon Licensed Marriage and Family Therapists
Oregon Licensed Mental Health Counselor
Oregon Certified Master Social Worker
CEU License Number
Thank you! The first part of your registration form has been successfully submitted.
If you are on staff or a volunteer with Ashland Supportive Housing, your registration is now complete, and you will receive a confirmation email in the next 24-48 hours..
All others must complete their registration by submitting payment now. Please select your rate and click “Pay Now” to be directed to PayPal.
You will receive a confirmation email in the next 24-48 hours from
i firstname.lastname@example.org. If you have any questions, please email i email@example.com