Self-Attunement Series Intake Form

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All new students of the Self-Attunement series must complete this form before attending.

Email *

Name

What are your pronouns? *

What brings you to sign up for this series?

What is your experience with Authentic Movement, if any?

Tell me a bit about your relationship to embodiment.

While this practice is not therapy, it may be therapeutic in nature. Do you have support outside of this group for any personal integration that may be helpful?

Yes

Is there anything else you would like the facilitator to know about you, where you are at in your life, or what you hope to gain from this experience?

Submit

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