Mindful Bardō
A mindfulness meditation support and learning group to help you navigate the grief and transformation associated with the loss of a significant other.
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Name (First and Last) *
Age *
Address *
Email *
Phone *
Please describe your experience, if any, with mindfulness meditation practices *
Please check all that apply *
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Have you experienced trauma or chronic depression symptoms that may require professional support? If so, please explain. *
What are your hopes and expectations for joining this group? *
Comments (Please share any additional information that will help me understand your interest and situation) *
Are you available every Saturday, from 11am-1pm from January 9 through February 20, 2021? *
Registration: The registration fee for this group is $20 a session/$140 total. If you are contacted, you will receive a confirmation email with a link to pay for your registration via PayPal. The cost for registration is non-refundable, unless the group is cancelled due to underregistration or unforeseen circumstances, at which time you will receive a full refund. ***Please know that if you register, you will be voluntarily participating in this group, including all techniques and exercises shared by the facilitator. By registering to this group, you understand that this is a non-professional, support and learning experience and not a substitute for therapy, medical diagnosis and/or treatment. You must be in adequate physical and mental health to participate and the facilitator reserves the right to refuse your participation based on your answers to the questions on this form. Further, if you find that you experience discomfort or there is any cause for concern during or after the group's activities, you should stop immediately and consult a professional healthcare provider. By printing your full name below, you agree with these conditions and waive any claim against the facilitator, Mindful Bardō or CEN Professional Learning. *
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