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Supporting You Within The Community

First name*

Last name*

Email*

Phone*

Have you ever attended coaching session?*

yes

Did you find them helpful? And why or why not?

What area of your life would you like to improve?

What kind of free info would you benefit from? ( all that apply)

Self Care Information

Self Inventory questionnaire

Mindfulness Information

Outside resource links for health/wellness

Meditation recordings

Tips for better living/lifestyle habits

Would you consider coaching now?

yes

within the next year

Have you ever attended a wellness/health retreat?*

yes

If yes, where?

Would you be interested in attending a wellness or health retreat?

yes

maybe

Multi choice

Option 1

Option 2

What would your interests be for a Wellness Retreat? (check all that apply)

Meditation or Reset Retreat (relaxation/reset)

Yoga/Hiking/Meditation with a few classes

Emotional Healing/Mindfulness workshops (with yoga/meditation)

Health/Wellness Education and Lifestyle

Healing Health and Ayurvedic Treatments

Plant Medicine

Ayurvedic Lifestyle Education

Would you prefer a weekend or 4/5 day stay?

weekend

longer stay

Do you currently have a meditation practice?

yes

How far would you travel to a retreat? (check all that apply)

local/drive

fly within U.S.

International Destinations

Would you like to be (pre) notified of upcoming retreats?

yes

Let's Connect

First Name

Last Name

Phone

How can I help you?

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Email: BonnieLBartlett@gmail.com

Phone: (831) 809-1864

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by Bonnie Bartlett

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