Breathwork Circle Application

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Tell me about who you are and why this circle would support you!

Email *

First + Last Name *

This is a 4-month commitment. Did you catch that? *

Yes

This is a sliding scale offering. Which supports your lifestyle most? *

$77.00 a month

$99.00 a month

$122.00 a month

What Group Time Are You Interested In *

Group One: ONLINE - Friday mornings 10:00-11:30am

Group Two: ONLINE - Monday evenings 6:00-7:30pm

Group 3: IN- PERSON (in Lawrence) - TBD

I am also open to you sharing times that work well for you and once we have enough people we can make magic work!

If you could wave a magic wand, what would you change about your life right now? *

Do you have prior experience with breathwork (generally, conscious connected breath at a faster than normal pace)? *

Do you have prior experience with energy healing? *

How much experience do you have doing one-on-one healing work? *

How much experience do you have doing group healing work? *

Please share any medical or psychological conditions you have along with a brief explanation of the state of that condition today. *

Anything else that feels important to share? *

Thank you for taking the time to fill this out.

I will be in contact shortly.

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