Coming Home To Your Body Retreats
with Cassie Thomas and Jessica Maguire
Life situation and/or occupation
Current meditation practice (if any):
Please list any retreats you have attended in the past five years, including tradition teacher, year and length.
Current physical, mental/emotional or spiritual issues that may make meditation difficult for you at this time
Many meditators are on a healing journey. On meditation retreat individuals may experience strong physical and psychological states. Please answer the following so we can care for you appropriately. Do you have any current or previous drug (including alcohol) abuse or addiction issues?
Do you have a current or previous diagnosis or treatment of a mental illness (psychological or psychiatric)?
Do you have any current or previous medical conditions that require attention during the retreat?
If you answered "Yes" above please give further information about your conditions:
Are your symptoms well controlled
Have you ever had any problems abruptly stopping alcohol usage?
Do you currently use recreational drugs e.g. marijuana, amphetamines, ecstasy?
Do you have a history of emotional instability during meditation retreats?
How do you assess your current ability to work with emotional swings?
If you are taking any prescription medications for physical or psychological conditions please list each medication as well as the condition it is being used to treat below. Please list any current therapist or dotor you are working with.
Do you have any conditions that prevent you from participating in sitting and walking meditations or yoga?
Gymea Retreat Deposit