Intake form

Help us serve you better

Name *

Email address *

What services are you interested in?

Please select at least one option.

Kundalini Yoga

Reiki

Meditation

Wellness Coaching

Workshops

How did you hear about us?

What is your current level of experience with kundalini yoga or reiki?

What are your main goals for participating in our programs?

Do you have any medical conditions or concerns we should be aware of?

What days and times are you available for sessions?

Additional questions or comments

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