1. What area(s) of well-being feel most important to you right now? *

(check all that apply)

Physical health

Mental health

Emotional health

Spiritual health

Relationships + connectivity

Work-life balance

2. What wellness practices are you interested in exploring with us? *

(check all that apply)

Yoga/mindful movement

Meditation

Sound baths

Self-reflection (i.e. journaling, therapy, etc.)

Mindfulness

Other

3. What other wellness practices interest you? *

(check all that apply)

Reiki/energy healing

Sound baths/sound healing

Herbal medicine

Art therapy

Dance/interpretive movement

Other

Name

First Name

Last Name