Intake Form. Name * First Name Last Name Email * Phone (optional) (###) ### #### Have you ever meditated? * Yes No If so, how often do you meditate? Daily Weekly Monthly Yearly Tell me briefly in 1-2 sentences what brought you to these sessions. Are there any goals you would like to accomplish with these sessions? On a scale of 1 to 5, how would you rate your overall happiness? (1 being the worse & 5 being the greatest) * 1 2 3 4 5 On a scale of 1 to 5, how would you rate your current stress level? (1 being the worse & 5 being the greatest) * 1 2 3 4 5 What have you done in the past to cope with stress? Thank you! Your Intake Form has been received.
