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Your Personal Information

Full Name

Phone (Prefix country code)

City & State

Your Health Background

What condition(s) are you currently managing?

Have you practiced any form of meditation, breathwork, or holistic healing before?

Are there any physical limitations or accommodations you would like us to be aware of?

Experience Preferences

Preferred Duration

Preferred Dates/Availability

Your Expectations

What are you hoping to gain from this retreat? (Select all that apply)

Learning to manage pain through breathwork and meditation Building emotional strength and resilience Reducing stress and anxiety related to chronic pain Developing a sense of calm and control over my experience Connecting with others on a similar journey All of the above

After the Retreat

Would you be interested in ongoing support after the retreat?

Is there anything else you’d like Sitender to know before the retreat?

I confirm that I have read and agree to the terms and conditions (add terms page link), including cancellation, data protection, and general terms.