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 SANCTUARY RETREATS HAWAII SURVEY
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We are happy you found your way here and we look forward to connecting with you! Tell us a little bit about you.
FULL NAME *
EMAIL *
PHONE NUMBER (PLEASE INDICATE IF NON U.S. FOR WHATSAPP) Our number will appear in signature of the email we will be sending to you.  *
FACEBOOK NAME:
INSTAGRAM HANDLE:
DATE OF BIRTH
MM
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DD
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YYYY
Include the time and place of your birth, if desired, for an astrological chart print-out for future discussions of archetypes.
Where do you call home? *
Are you interest in a scheduled retreat program or a custom retreat by design? Please explain. 
What inspires your interest in this retreat what would you hope to receive through this experience? *
Do you currently have self care and personal development practices; and what are they? *
What transformative retreats, workshops, facilitator trainings, self healing, or personal development workshops have you taken that you feel have prepared you to dive deeper with us? *
Are you emotionally and mentally available to take personal responsibility for where you are in life? Are you willing to do your own internal work to create positive change in your life? *
 How do you currently relate with your intuition, your embodied wisdom? *
Can you agree to these statements? 
1. I’m willing to be challenged on my assumptions and my limiting beliefs. 
2. My healing is my responsibility. 
3. I understand that my success is determined by my capacity to listen, see and receive my own self process. 
 *
Have you been diagnosed with any mental illnesses or are you recovering from any deep trauma? (Your response is completely confidential and just helps us to know how we can best support you.) 

Disclaimer: Information provided on this web site and at the retreat is neither intended nor implied to be a substitute for professional medical advice and is not meant to replace the services of a therapist; nor does it constitute a doctor-patient relationship. If you have, or suspect you have, an urgent medical problem, we suggest you promptly contact a professional healthcare provider.
*
Do you have any physical limitations or any injuries we should be aware of that would inhibit you from participating in yoga, dancing, hiking, water sports, etc? *
Do you have any health issues that we need to be aware of while hosting you in the retreat? It is very important and highly appreciated that you are upfront about any and all things that might affect your experience with us. Thank you :) *
Do you have dietary restrictions/preferences/allergies? *
Do you have animal allergies? Please note a cat does live on the property. She is mostly outdoors; however, she does also come inside. *
How did you hear about us? :)
Is there anything else you would like for us to know? *
Mahalo for your interest and/or your commitment to explore your inner and outer world with us! We are truly honored and grateful to have the privilege and responsibility to act as guides to you on your journey. We look forward to connecting with you soon. Look out for an email from us in the next day or so with more information. 

🙏🏽🌈✨

Mahalo for your Kokua!

Aloha Ke Akua,

The Sanctuary Retreats Team
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