Creating Your Retreat at Anahata
Congratulations for creating this special time for yourself! This form will help us to optimize your experience. We may follow up with a brief phone call to be sure everything is in alignment with your goals. After we've received this and a deposit, we'll send a welcoming email with more info, suggestions for what to bring, directions, etc. Feel free to contact us at anahata.edu@gmail.com with any questions you might have!
Email address *
Your Name *
Your answer
Cell Phone *
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Preferred Start Date of Your Retreat - please give us some options if possible! : ) *
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Plan your retreat... *
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Enhance your retreat with additional wellness services.
What best describes your dietary preferences while you are here? Please check all that apply. *
We provide delicious, colorful meals with an emphasis on organic, local and sustainably sourced foods. We accommodate a wide variety of needs and preferences.
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Please add any details about your food preferences.
Do you have any allergies or foods you avoid or dislike? Describe your ideal breakfast - lunch - dinner and favorite foods.
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Please briefly describe your main goals and aspirations for this retreat.
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Do you have any other information to share, questions, or special requests?
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Emergency Contact Person & Phone Number *
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Thanks so much! We'll be in touch
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