BOOK YOUR SESSION Name * First Name Last Name Email * Instagram Handle * Location + Time Zone * What type of session are you interested in? Breathwork + Meditation Session Elevation Session (Coaching) Hybrid of the above Briefly tell me about your meditation + breathwork experience. * Do you have a breathwork or meditation practice? Have you practiced privately and/or in group settings? What is your intention for this session? * How can our work together best support you at this time? Are you looking for release, expansion, clarity, etc? Do you have history of heart disease, high blood pressure, or cardiovascular issues? * Yes No Women - Are you pregnant or on the first 3 days of your cycle? Yes - Pregnant Yes - on my cycle Neither How would you rate your mental health at the moment on a scale on 1-10? * 1 being the worst, 10 being the best 1 2 3 4 5 6 7 8 9 10 How would you rate your stress levels at the moment on a scale of 1-10? * 1 being the worst, 10 being the best 1 2 3 4 5 6 7 8 9 10 Is there anything else coming up for you that you would like to share? What is your general availability (time/day) for a session? * Thank you - I’ll be in touch soon!
