top of page

October 2023 - Maui
Awakening Through Grief Retreat Registration

Is it okay to leave a private voice message?
What is the best way to contact you?
Marital Status
Do you have children?
Have you ever participated in a Mindful Grieving Program in the past?
Food Restrictions
Food Preferences
What kind of loss have you experience (select all that apply)?
When did your loss(es) occur?
Have you had more than one loss in the past 5 years?
Are you currently in counseling?
Have you experience any events that you would consider traumatic, whether related to this loss or not?
Have you ever attempted or considered suicide?
Are you currently taking medications for depression, anxiety, or other mental health issues?
Have you ever been hospitalized for psychiatric or other reasons?
Do you experience fighting in your household?
Do you currently practice yoga?
Are you currently pregnant?
Do you have any injuries or disabilities that will affect your practice?
bottom of page