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Services
Massage Therapy
BioDynamic Breathwork
Group Offerings
Retreat Chef
Information
About
Testimonials
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Policy & Agreements
Contact
Page 4 of Questionnaire
Are you currently taking or have been prescribed psychiatric medication?
Yes
No
If yes, please share which medication, for what diagnosis, for how long and the results?
SIGNIFICANT LIFE EVENTS
Please share about any traumatic experiences. These may be physical and/or psychological, emotional in nature having occurred at birth, your developmental years, a one time shock/situation:
Generational trauma
(parents, grandparents, etc):
Your birth story if known
vaginal, c section, drug use during pregnancy or birth
Stressful family circumstances at birth &/or throughout development
Please add any other relevant information or elaborate on the questions above
What are you hoping to experience, learn, release, transform, integrate, take away from your BBTRS sessions?
Thank you so much for taking the time to be thoughtful. I am looking forward to our time together.
Thank you! I will be in touch with you shortly.
