WELCOME TO YOUR SACRED SERENITY RETREAT EXPERIENCE WITH LERAE

Reconnect with Your Essence, Reclaim Balance, and Make Self-Care a Non-Negotiable Priority. Transform Your Life Today!

Sacred Serenity Retreat Intake Form

Please fill out this form for your initial assessment.

Phone Number

Please list some of your favorite fruits, vegetables, and grains.

List any dietary restrictions or preferences (e.g., vegan, gluten-free, etc.)

Are you currently taking any medication?

What are your primary wellness goals for attending this retreat?

How would you rate your current level of physical activity?

What are you hoping to achieve during the retreat?

Are you prepared to fully commit to the retreat schedule and activities?

Yes

Form submission[]

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