• Embodied Flow: A Somatic Journey into Movement, Medicine & Presence

    Embodied Flow: A Somatic Journey into Movement, Medicine & Presence


  • Thank you for your interest in our event. We invite you to complete the application thoughtfully and honestly. Your responses are fully confidential, encrypted, and accessible only to the Love Awaken team. Once we
    receive your application, we’ll reach out to schedule a
    brief call to connect and discuss next steps.

     

  • Date:
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Are you on signal? (https://signal.org/download/)
  • Purpose

  • Prior Journey Experience

  • Health

  • Could you be pregnant?
  • Check any of the following medications you are currently taking (it is essential for your safety that you list all Rx meds):
  • Are you currently taking an other medications?
    Rows
  • Check all conditions that apply to you (past or present):
  • Are you currently experiencing any of the following symptoms:
    Rows
  • Emergency Contact

  • Format: (000) 000-0000.
  • Should be Empty: