WORKSHOPSINTAKE FORM Main Contact * First Name Last Name Organization Name (if applicable) Email * Phone * Country (###) ### #### 1. Preferred Date and Time? * 2. Location (On-site or off-site)? * If on-site, please provide the address. 3. Number of Participants? * 4. Age range of participants? * 5. Previous Experience with Breathwork? * (Beginner/Intermediate/Advanced) 6. Any Health Concerns or Medical Conditions? * 7. Duration? * 2 hours 3 hours Custom (please specify below) If you've chosen 'custom,' kindly provide specific details or preferences to tailor the experience according to your unique requirements. 8. Desired Theme or Focus? * 9. Specific Goals and Outcomes? * 10. Accessibility or Special Requirements? * 11. Extra Materials (Yoga Mats or Chairs?) * Please provide a list of materials you currently have or may require. 12. Feel free to share any further questions or comments by noting them down below: Thank you! We will get in touch soon!