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Transparency behind our procedure is important to us.

We want to ensure your success.
This program requires a twice a weekly commitment to a
one-hour training session. Consistency and the ability to show-up is key to succeeding in this
program. If you cannot show up consistently you may need to defer to a later time.
Please answer the questions below. Our client coordinator will contact
you to have a conversation about opportunities to enroll on MINE after completing this form.

M.I.N.E. Readiness Questionnaire

 Please take a few moments to answer this readiness questionnaire:

Are you in safe stable housing?
Are you capable of communicating with your trainer or MINE representative if your circumstances change and you are no longer able to meet the schedule demands of the program? Avoidance is not communicating.
Do you consider yourself safe right now physically, emotionally, and psychologically in your living space?
Do you have a system in place where you can go for emotional and psychological support?
Do you have 2 hours a week that you can consistently set aside for your one hour training session?
Do you understand there will be days where you might have low mood or feel overwhelmed or not want to go to your training session?
Do you understand that is also normal and part of the process?

Thank you for submitting!

​Please fill out the Health History Questionnaire.

We Need Your Support Today!

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