Minds Matter Application
Name *
Your answer
City, State, Country *
Your answer
Birth Month and Day *
Your answer
Is your goal concern your career, your relationships (professional, romantic, non-romantic), or yourself? Choose all that apply *
Required
Can you commit to 14 weeks of in-person and/or phone-based meetings that will consist of practices to overcome obstacles and encourage you create new habits? *
What is your experience with Yoga? *
Your answer
What is your experience with Ayurveda? *
Your answer
What is your experience with Meditation? *
Your answer
If you are currently under medical care for physical/mental conditions, will you continue those support strategies throughout our mentorship? *
What questions/concerns do you have about this mentorship? What obstacles do you foresee? *
Your answer
Email *
Your answer
Phone Number *
Your answer
Preferred Contact *
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