1. religion and spirituality
2. buddhism

A 6-week mindfulness course to improve the quality of your life
Do you race from task to task in your life, often wondering where the time went at the end of the day? Do
you feel like you are just going through the motions of your life? Is your mind constantly reviewing your todo list, even when you want to relax? Are you a world-class multitasker, with your attention in at least two
places at once at all times? If you answered yes to any of these questions, or simply have an interest in
exploring the concept of mindfulness, this course is designed for you.
There is now a robust body of research showing that mindfulness can help with stress, anxiety, attention and
focus, depression, memory, self-esteem, relationship health, and productivity. How does it work? Brain
imaging research shows us that a regular mindfulness practice can cause beneficial changes in our brain. Wow,
that's impressive! What does this mean for day-to-day life? Mindfulness improves our abilities to manage
stress and our emotional reactions, allowing us to be more fully present and engaged in our lives. It can also
foster a better sense of clarity and balance. Are you curious to see what changes could happen in your life?
We will explore many facets of mindfulness including:
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Various styles of meditation
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Mindfulness in everyday activities
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Breath and body awareness
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Emotional awareness and regulation
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Self-compassion
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Mindfulness for relationships
Course Details:
Dates and Time: Tuesday evenings, beginning May 19 and ending June 23, 2015, from 5:15pm—6:30pm.
Location: Meetings will be at my office, 8340 Meadow Road, Suite 224, Dallas, TX 75231.
Cost: $225. See Perks for more information about what this includes.
Perks: Group size will be limited to help create a safe place to learn, practice, and share. Each participant is
eligible for one complimentary 15-20 minute coaching session during the 6-week course. Each participant will
also be provided with guided imagery audio files to help with their practice outside of our meetings.
To inquire or register, please call my office at 972.742.2186 and leave your name, phone number, and email.
You are also welcome to email me at doctorjen@jenniferhartman.com.
*Note: This course is not a psychotherapy group and is therefore not intended to serve as stand-alone treatment for mental illness or emotional problems.
Registration and Consent for Psychoeducational/Skills Groups
Full Name
Date of Birth
Mailing Address
Home Phone
Cell Phone
Email address
Emergency Contact: Name/relation
Phone
Who recommended this group?
May I thank them? Y
N
If you are currently seeing a psychotherapist and/or psychiatrist, please list their name(s) and phone number(s) below:
I am honored to have you join the Mindfulness group and look forward to getting to know you during this time of learning
and possibility. For your consideration, here are the policies for this group:
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This group will meet for 6 consecutive weeks on Tuesday evenings from 5:15pm—6:30pm, from May 19 through June
23, 2015.
Full payment of $225 is due at the time of registration. You may cancel your participation for a full refund minus a $10
processing fee up until May 4. If you notify me of cancellation between May 5 and May 18, you may be eligible for a
full refund minus the $10 processing fee if I am able to fill your reserved slot. If I am not able to fill the slot before May
18, you will be eligible for a refund of $125.
This course is designed as a psychoeducational group for participants to learn and practice mindfulness skills. It is not
a psychotherapy group, nor is it designed to treat specific mental illnesses or emotional problems. Participation in this
course alone does not constitute a therapy relationship with Dr. Hartman. Unless otherwise agreed upon with Dr.
Hartman, her role for the duration of the course is as a psychoeducational teacher and facilitator.
On-time arrival is vital as each group will begin with an introduction and practice of a mindfulness skill. If you arrive
once the mindfulness exercise has begun, you may be asked to wait to join the group until we have completed the
initial mindfulness exercise.
You will be encouraged, but not required, to share your thoughts and experiences as you learn and practice
mindfulness skills. This is part of the beauty of learning these skills in a group: we get to learn from each other! To
help facilitate your learning and growth, you will also be encouraged to keep a journal of your experiences applying
mindfulness practices in your life. Because this is not a psychotherapy group, you will not be expected, nor will there
be time, to share significant detail about your personal life and history.
If you are currently seeing another psychotherapist and/or psychiatrist, it is important for them to be aware of and
comfortable with your participation in this course.
Any personal growth and exploration experiences can carry this risk of bringing to light unresolved issues or triggering
old hurts. In a psychoeducational course of this nature, the risk of high levels of distress is fairly low. However, if you
find yourself distressed with the material and practice, it is important to let me know this as soon as possible. We will
think together about whether it is advisable to continue in the course, and if needed, I will offer referrals to therapists
who can help you work through your triggers and distress.
Again, I look forward to having you as a participant in the Mindfulness course. By signing this agreement, you are
indicating that you have read this page completely and have had all of your questions answered. You agree to the
provisions freely and consent to the group policies.
Student Signature
Printed Name
Date________________________