Page 1 of 2

Sacred Breath / Micro Journey

Mini Dose Breathwork Workshop 
Duration: 4 hours
Date: Saturday, Feb 1st, 2:30-6:30 pm 
(space is open for people to stay later)
Location: Passage House
Investment $150 - $300

First Name

Last Name

Email

Phone


How did you find me?

What inspired your interest in this workshop? 

There are greater benefits in working this way consistently for several sessions. Are you interested in doing this work in a series?

There are greater benefits in working this way consistently for several sessions. Are you interested in doing this work in a series?
A
B
C

Have you worked with plant medicine or psychedelics before?

Have you worked with plant medicine or psychedelics before?
A
B
If yes, please share some of your experience.

Do you have any health concerns regarding this kind of work? If so, please elaborate

Are you taking any medication, drugs, or alcohol? If so, please elaborate.

What is your experience with Breathwork?

Can you give me a brief description of your relationship to spirit (spirituality)?

What are you focusing your attention and energy on in your life?

What are you ready to transform or activate in your life?

Thanks so much for taking this important step towards your healing and expansion.
I look forward to connecting with you!