Please share as much as you’d like to help us serve you better.

Name

First Name

Last Name

Phone

(###)

###

####

Emergency Contact

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Gender

Pronouns

Sexual Orientation

Age

What are your objectives in coming to Grateful Already?

What extra services might you be interested in?

Massage ( 150 )

1-on-1 Custom Medicine Journey ( post-retreat )

Couples Medicine Journey ( post-retreat )

Private Spiritual Guidance ( 150 )

Private Yoga/Meditation Session ( 150 )

Please elaborate or ask questions, if needed.

How did you hear about us?

Please share who you live with

Are you in partnership?

Do you have children?

Have you practiced meditation or yoga?

What do you want to transform?*

What are your self care practices?*

What are you most looking forward to or hoping for, on the retreat?

Have you been in structured silent practice before?

Do you take any medications or supplements?

Do you have any allergies to food or medications?

Do you need any accommodations to be able to participate?

What would you like MORE of in your life?

What is your favorite way to FEEL?

Anything else that you would like to tell us?

Thank you so much for sharing!