Begin your 1:1 Healing Journey

You’ve taken in the information — now something in you says yes. This form is the first gentle step in bringing that yes to life.

These retreats are personal, sacred, and slow. There’s no rush, and no perfect words needed — just a willingness to begin where you are.

Once you submit this form, I will be in touch to have a conversation, clarify any details, and guide you through what’s next.

Every retreat is different — and every detail matters. We’ll work with you to create a seamless, culturally respectful experience.

Let’s begin the conversation.

ABOUT YOU

Name

First Name

Last Name

Email Address

Phone

Country

(###)

###

####

WHERE YOU"RE AT

Are you currently working with a therapist or other practitioner?

What’s bringing you to this retreat?

A few words, a feeling, or just a sense — whatever you’d like to share.

RETREAT DETAILS

Preferred dates or general timing (e.g. October 2025, early next year, etc.)

Preferred dates or general timing

(e.g. October 2025, early next year, etc.)

Length of retreat you’re drawn to

(e.g. 3 days, 5 days, 7+ days — or unsure)

PRACTICAL BITS

Any access, mobility, or dietary needs we should know about?

Is there anything else you'd like us to hold as we begin this process together?

Boundaries, stories, questions?