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Email
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Full Name
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Date of Birth
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Phone Number
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Occupation
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Address from where you'll be attending our sessions
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What does your lifestyle, diet, and exercise routine look like?
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Do you have a meditation or other spiritual practice?
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Are you currently in therapy and/or other support groups?
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Have you practiced breathwork before? If so, please share a bit about your experience.
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What are your hopes, desires, and intentions for our time together practicing breathwork?
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Anything else you'd like me to know - thoughts, questions, concerns?
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How did you hear about us?
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