Immersive Breathwork Retreat Intake FormBella Riva Hotel 5*MaY 19-22, 2022 Name & Family Name * Phone * (###) ### #### Email * Address: (Street - # - Zip - Province - State - Country) * Age * Occupation * 1) What are the main reasons that led you to this experience of personal rediscovery? * 2) Have you ever participated in breathworks? If so, describe them briefly. * 3) Have you had experiences in the past that have led you to states of non-ordinary consciousness? If so, describe them briefly. * 4) What are your usual practices for psychological and spiritual support? * 5) How do you judge your physical condition? * 6) Are you taking medicines for physical and / or mental problems? If so, describe them briefly. 7) If you think there is something important to share before embarking on this path, please describe it below: * 8) Do you follow a particular diet? Do you have intolerances? * Thank you!
