Healing Arts Chicago | Interest Form for Artists

Thank you for your interest in Healing Arts Chicago.

Please use the following form if you are an artist interested in participating in Healing Arts Chicago. Responses to this form will be reviewed the weeks of March 31, June 23, and September 15.

For more information on the program, please follow this link.

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* 1. Please share your name.

First name

Last name

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* 2. Please share the best phone number to reach you on.

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* 3. Please share your email address.

Email address

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* 4. Are you a resident of the City of Chicago?

Yes

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* 5. Do you currently have an arts and health, wellness, and/or healing practice?

Yes

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* 6. Please describe your artistic and/or health/wellness/healing practice. (5 sentence maximum)

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* 7. Please share a link to your work. (website, social media handles etc)

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* 8. Please share the ways that you might be interested in Healing Arts Chicago. Select all that apply.

I would like to apply to be a part of a future cohort of artists, pursing community health worker certification and an apprenticeship in Chicago of Chicago mental health clinics. (Please note that it is not guaranteed that there will be future cohorts of this program.)

I would like to work with one of the current Healing Arts Chicago artists, supporting their arts services.

I am an artist already using the arts for healing, and would like to be part of a broader network of artists doing similar work.

I am generally interested in the program and want to receive updates via email.

Other (please specify)

Healing Arts Chicago | Interest Form for Artists

Question Title

* 1. Please share your name.

Question Title

* 2. Please share the best phone number to reach you on.

Question Title

* 3. Please share your email address.

Question Title

* 4. Are you a resident of the City of Chicago?

Question Title

* 5. Do you currently have an arts and health, wellness, and/or healing practice?

Question Title

* 6. Please describe your artistic and/or health/wellness/healing practice. (5 sentence maximum)

Question Title

* 7. Please share a link to your work. (website, social media handles etc)

Question Title

* 8. Please share the ways that you might be interested in Healing Arts Chicago. Select all that apply.

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* 9. Is there anything else you would like to share with the Healing Arts Chicago team?