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Email
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Your email
Name
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First and Last Name
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Age
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Occupation
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Phone number
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Your answer
Address
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City
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State
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What is your biggest challenge?
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What are you looking for from your retreat experience?
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Do you practice Yoga, Qi Gong, Meditation?
Often
Sometimes
Rarely
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Do you practice Thai Massage?
I'm a beginner
I am a Therapist
I like to receive them
I've never had one
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Please describe your ideal day...
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Are there any medical conditions we should know about?
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Do you agree to offset the carbon footprint from your travel? We will show you how.
Yes
No
Maybe
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If someone referred you, please tell us so we can thank them.
Your answer
Once your form is submitted, you will receive a link to schedule a call with us to see if this is a good fit for you. Please note, your retreat space is not confirmed until you have made your deposit.
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