Individual Sessions with Michael Brian Baker
Pre-Session Questionnaire: Please answer the questions below prior to your session with Michael. All information will be kept confidential.
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Email *
First Name *
Last Name *
Phone Number *
How did you hear about this work? *
Please clearly describe what you would like to work on in your session(s) with Michael: *
What areas of your life are you interested in expanding & growing in? *
Required
What interests you in pranayama/breathwork? (Choose as many as apply) *
Required
On a scale of one to ten, please rate the commitment you have to yourself and your personal evolution: *
Very hesitant
100% in!
Do you have any current physical injuries or medical conditions? If so, please describe: *
Please share if you have experienced or are experiencing (Choose as many as apply): *
Required
If you checked anything above, please use this box to provide details, or if there is anything else you'd like to add, please share!
Please list any medications you are currently taking or have taken within the last 2 months: *
Are you interested in receiving your sessions: *
Do you get massage regularly? *
If you are receiving your session in person, would you like touch to be incorporated? (Touch is not required for breathing sessions, but may incorporated to assist the practice with consent. The touch does not involve deep tissue work, & is very gentle and minimal) *
Do you have allergies to any of the below items? *
Required
I understand the information on this website and services provided by Michael Brian Baker are not the medical advice from a doctor or other professional healthcare provider. If I have any specific questions about any medical matter I agree to consult my doctor or other professional healthcare provider. I think I may be suffering from any medical condition, I agree to seek immediate medical attention. Note: You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website. *
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