The Airess: The Rise of the Feminine, 1.26.2024

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Dear & Divine Women,

Thank you for your trust. Our inner exploration begins here, with honesty, vulnerability and care. Please rest assured that all the information you share will forever remain confidential.

The Airess gatherings are limited to 10 women only and the cost for the experience, which includes preparation, journey and integration is $360. Once you've completed this form, please Zelle a 50% ($180) deposit to elian@woomcenter.com. If you'd like to schedule a discovery Signal call, please email the above.

With Love & Gratitude,

🤍🙏🏼
Elian

Name *

Email Address *

Phone Number *

Age *

How did you hear about The Airess? (please give the name of the person who referred you) *

Have you previously experienced a journey through non-ordinary states of consciousness? *

Yes

If yes, please elaborate on the context and setting

Do you have any other type of meditation or mindfulness practices? *

Yes

If yes, please elaborate

What brings you to this work now? *

What is most present in your mind, body, and soul at the moment? Usually these are the first things that come to mind (i.e. challenges, inquiries, relationships, work, traumas, curiosities, etc.) *

How have you been meeting these aspects of yourself? And what have you been finding? *

What is your relationship to femininity in general and specifically to your own femininity? *

Please feel free to share any specific intentions you have for the experience.

I understand that I must share my history of taking antidepressant medication (SSRIs, MAO inhibitors) or anti-hypertensives (high blood pressure medication). *

No, I do not have a history of taking antidepressants or anti-hypertensives

Yes, I have taken or am taking antidepressants or anti-hypertensives and will list them below

If you checked yes, please list them below

Please list ALL other medications below (or write none) *

Please list ALL supplements below and what they are for (or write none) *

Please share if you have any history with PTSD, addiction, anxiety, depression etc.

Please list any medical issues or concerns you have as well as family history of mental illness.

Please include the name and phone number of an emergency contact *

This work requires a clean system. Please agree to not eat meat, drink alcohol, use recreational drugs, or take any medication at least 48-hours prior to the meditation (preferably 72-hours). *

I agree

I disagree

Please agree to keep all information about the journey private. This includes names and contact information of the facilitators and participants and the location. *

I agree

I disagree

Any other questions or comments

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