Application for a 3 Day Immersion with Dr. V

A 3 day immersive with Dr. V means you will access 6 full sessions over the course of 3 days with processing and pattern recognition. This is the deep dive for growth, stubborn patterns, and going deep to the inner self.

Why book a 3 day immersion instead of booking directly on Dr.V's in person schedule?

This offer is an immersive experience. Dr.V clears her entire schedule to accomodate full day access to her services.

First Name *

Last Name *

Date of birth *

Address

Street Address

City

State

Country

Postal Code

Email *

Phone *

Preferred contact method: *

Phone

Zoom

Please provide a brief description of what you are seeking the 3 day immersion for (healing, business growth, consulting): *

How long has this been an issue for you: *

What has to tangibly change in your life/body to make the experience worth it? *

What would have to change in 30 days for you to see the benefit of this experience? *

Have you experienced significant trauma, grief, or major life events that may relate to your symptoms? *

Are you currently experiencing: suicidal thoughts active addiction psychosis / mania severe eating disorder symptoms? Please explain *

Do you currently have a support system (therapist, coach, partner, close friend) you can lean on after deep work? *

The 3-Day Immersive is $10,000 USD (plus travel costs if applicable). Are you ready to invest at this level if accepted? *

Yes

I need to discuss payment options

If accepted, how soon can you commit? *

Immediately

Within 7 Days

More than 7 Days

Payment preference: *

Credit Card

Paypal

The 3-Day Immersive is $10,000 CAN (plus travel costs if applicable). Are you ready to invest at this level if accepted? *

Yes

I need to discuss payment options

If accepted, how soon would you commit? *

Immediately

Within 7 Days

More than 7 Days

What is your payment preference? *

E-transfer

Paypal

Credit Card

What are you most afraid will happen if you fully heal? *

What would make this work unsafe for you? *

Why do you want to work with Dr. V? *

What do you feel I can help you see or shift that others haven’t? *

Is there anything you want me to know that you haven’t shared here? *

I understand my healing is my responsibility and this experience is a catalyst—not a guarantee. *

Yes

I will not book social events, work calls, or obligations during the immersion days. *

Yes

I am willing to follow integration practices for at least 7–14 days after. *

Yes

Upload a recent photo of yourself (helps Dr. V connect intuitively) *