Body Intelligence Retreat Form
Please take a moment to fill up this Retreat Form. We take your privacy very seriously. Your personally information is strictly confidential.
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Prefer not to say
We only recommend double occupancy if you are attending the retreat with a partner. Otherwise, we recommend that participants stay alone overnight as this is very much part of the mindful detox process)
If attending with a partner, please provide their name and age
Food allergies if any
Have you practiced yoga before?
Please describe your practice (how long have you practiced yoga, how often, and what type of yoga do you practice)
Have you experienced any of these conditions? (Check all that apply)
Acid Reflux (GERD)
Headaches / Migraines
Recurrent Ear Infections
Recurrent Sinus Issues / Infections
Invasive / Extensive Dental Procedures or Surgeries
Medication that you are currently taking and conditions they are related to
Any other health concerns we should know about?
Other comments that may be important for us to know
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This form was created inside of Wellness Collective.