IHPL - Pregnancy Loss Practitioner Application

Pregnancy Loss & Trauma informed Specialist Application.

ARE YOU; an Angel Mum who's loss is recent or some time has passed, your healing journey is ever evolving BUT you have an inner knowing you want to become the support person for another loss Mum.


You are a Service provider wanting to confidently support Angel Mums with the Pregnancy Loss Practitioner Program.

 BIG LOVE, Sharna xx

Click the button below to start.


Question 1 of 22

Your Full Name & email?

Question 2 of 22

What is your Facebook &/or Instagram handle?

Question 3 of 22

What timezone are you in?

Question 4 of 22

Where are you in your life currently? 


Loss Parent with a burning desire to support other loss mums


A service provider looking to confidently support your clientele who have experienced loss?

Question 5 of 22

Briefly describe what it is you're struggling with the most right now?

(Example: no structure? Desire to support but don't know how?)

Question 6 of 22

What does healing mean to you?

Question 7 of 22

Loss Parent;

What would being able to continue your healing WHILE learning how to support others mean to you?

Question 8 of 22

Service Provider; 

What would be the BIGGEST BENEFIT for you enrolling into the Practitioner Program & getting the system to support other loss parents?

Question 9 of 22

Service Provider;

What would integrating a proven framework & added knowledge & skill set to deepen your support for your women clientele mean to you & your business?

Question 10 of 22


What is your GOAL or FUTURE VISION for becoming a Pregnancy Loss Practitioner? 

Question 11 of 22

What made you decide to apply with me?


What made you reach out today & take interest in The Pregnancy Loss Practitioner Certification?

Question 12 of 22

Why is NOW the best time for you to undertake this next part in your growth & evolution?

Question 13 of 22

How committed are you to deepening your ability to move through your healing? OR to deepening your support for your women clientele?






Less than 5/10

Question 14 of 22

If you are a 6/10 or LOWER - What would get you to a 10/10?

Question 15 of 22

Are you willing to make your vision stand taller than any obstacle?


Yes, absolutely, I am willing to work on them & bring my vision into reality


Hmmm maybe? My vision isn't that strong


Nope, my obstacles are mountains that I CANNOT move! My vision can wait

Question 16 of 22

How did you hear about me? Just pop in the name of the place you saw me

or the person or business who referred you.

Question 17 of 22

Anything else you would like to add that I haven't asked?

OR do you have any questions?

I invite you to pop it in here x

Also make sure to follow me on instagram: @instituteofhealing_pl

Question 18 of 22

The Application into Pregnancy Loss Practitioner Certification is a selective process & only allows in people who are aligned.


I agree

Question 19 of 22

Are you really ready? 

Have you watched all the videos about the program & you are ready to jump in? 


YES!! I've watched them & I'm ready


No, I haven't watched them YET but I am carving out time


Straight up Nope!!


Yes, I've watched them but I have some questions to gain clarity around

Question 20 of 22

Investment into the certification is upwards of $3,000 USD.

Is this something you are prepared to invest into your expanding your skill set, your growth & transformation? 


Yes absolutely, I am ready!


It will be a challenge but i'm resourceful, i'll find a way to make it work


Possibly, Can we discuss payment options


No, this is a huge obstacle & it won't work

Question 21 of 22



1️⃣ Submit this form.

2️⃣ Your Application call - I will be in touch via Email or Social media to book this with you

3️⃣ Make sure you WHITELIST [email protected] emails so they don't go to Junk Mail


 Does this all make sense?





Question 22 of 22

Please retype your email & click submit

Confirm and Submit