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Ancestral Medicine

Payment Request & Work Trade Tracking Form

Please read carefully as the information has recently changed.

Please use the form below to submit a request for any type of payment or reimbursement from Ancestral Medicine. You’ll receive an email confirmation of your submitted request and a member of our team will be in touch if we have questions or need additional details.

Payment requests are processed on a weekly basis, usually on Wednesday or Thursday. US-domestic payees will receive funds via Bill.com, which may take a few business days to process. International payees will receive funds via PayPal through the end of Cohort Six. Those receiving payment for service to Cohort Seven trainees and beyond will need to establish a payee account with Bill.com.

Please note: Compensation received by Ancestral Medicine for paid services is considered independent contractor income. Any person eligible to work in the United States who earns $600 USD or more in contractor income within a calendar year will receive a statement of contractor income from Ancestral Medicine as required by U.S. federal law (1099-MISC) by January 31 of the following year. Payees will need to provide documentation prior to receiving payment. (This must only be submitted once.) Please see the relevant information in the Volunteering & Educational/Ritual Work section, located in the Practitioner Network Portal.

If you have any questions, please reach out to the team at info@ancestralmedicine.org. Thanks for your service!

Practitioner Payment Form

Name(Required)

First Last

Email(Required)

Your Paypal Email - International Payees Only (if different than the one above)

Service Provided:(Required)

60-minute Group Supervision: $100 (8006-1)

90-minute Group Supervision: $150 (8006-1)

60-minute Individual Supervision: $100 (8006-2)

90-minute Individual Supervision: $150 (8006-2)

Reimbursement for professional training/education costs (8006-3)

Guiding retreat/ or make-up sessions: $50 per session (8006-3)

Guiding a 90-minute demo session for trainees: $150 (8006-4)

Event facilitation for the Practitioner Network (8006-5)

Practitioner training applicant interviews: $35 each (8006-6)

Mentorship of practitioners in training (8006-7)

Mentor Assistant: $300 (8006-7)

Ancestral healing sessions provided for Ancestral Medicine Staff (8006-8)

Ancestral Lineage Healing breakout and discussion support: $25 per call (8006-9)

Anchoring/leading calls for online courses: $100 per call (8006-9)

Substituted for online course call leaders $100 (8006-9)

Multiple payment requests submission

Work Trade Hours

Other

With Whom?(Required)

Please list the names of interviewees and the dates interviews occurred(Required)

Before submitting this request, please enter your client or group supervision notes in the appropriate space in the Network Portal. By checking this box, you indicate that you’ve done this.(Required)

I have entered my relevant notes.

How many trainees are you mentoring?(Required)

Six

Seven

Eight

Nine

Ten

Base Compensation for mentorship is split into two payments (initial and final), please indicate the payment you are requesting:

Initial payment

Final payment

Please indicate dates of service, focus of work, hours worked, attendees, etc.(Required)

Course name(Required)

Number of calls anchored in the last month: $100 per call(Required)

Click below if you’re requesting the initial course support payment:(Required)

Initial, one-time payment for course orientation, notes, etc.: $150

Course name and date of substitute coverage(Required)

Number of hours worked and service provided(Required)

Total dollar amount requested(Required)

Please describe the events or sessions facilitated, dates of service, hours worked, agreed upon rate, number of attendees, etc.(Required)

Which AM staff member did you guide and on what date? If you are submitting for multiple sessions, please also indicate that here.(Required)

For which professional training are seeking support? What is the amount for reimbursement?(Required)

Please specify date, topic, and agreed-upon payment(Required)

How many people attended your event?(Required)

Do you have any advice or words of wisdom for someone holding this type of event in the future?(Required)

Please write a detailed description of the service provided (date, names of attendees if relevant, hours worked, agreed upon rate, etc.)(Required)

Number of calls supported:(Required)

Before submitting this request, please confirm you’ve entered a follow-up comment in the Course Supporter discussion space for each call you supported. By checking this box, you indicate that you’ve done this.(Required)

I have entered my relevant notes.

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