Follow the steps to complete your application successfully.

1. Press the ‘Get Form’ button to access the application and open it in the editing environment.
2. Begin filling out the form by entering your first name and last name in the designated fields.
3. Provide the date of birth (DOB) in the specified field to confirm age eligibility.
4. Enter your complete address, including city, state, and zip code, to ensure accurate contact information.
5. Include your email address in the appropriate field for communication purposes.
6. Select your preferred method of contact by choosing between call, text, or email.
7. Articulate your personal growth goals for the program in the designated section to help facilitators understand your objectives.
8. Explain your interest in the program and any challenging transitions or situations you are facing.
9. Indicate whether you have been given a formal mental health diagnosis by selecting 'Yes' or 'No.' If yes, provide details of your diagnosis and the date when you were diagnosed.
10. If you are currently taking medication, select 'Yes' or 'No.' If yes, complete the medication chart by listing the name, dosage, timing, and purpose of each medication.
11. Share any additional information that you deem important in the final section of the application.
12. If you require more space, attach an additional document that includes your thoughts and intentions for participating in the program.
13. Once you have filled out all sections, review your form for accuracy and completeness before submitting.
14. Submit the completed application along with any additional documents to Emily Heeren at emilyh@bamidbartherapy.org. You may contact her at 720-409-0486 for further inquiries.

Complete your Bamidbar Wilderness Therapy application online today!