The Alchemy of Dreaming: An International Authentic Movement Retreat Signup

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1. What is your interest in participating in this workshop?

2. What is your profession or area of study? Please describe the type of work you have engaged in, in what setting, and with what populations.

3. Please describe your background in Authentic Movement. Please mention any other experience in body/psyche disciplines (such as BodySoul Rhythms, Haikomi, meditation, dance, yoga, etc.) - a practice that involves bringing embodied material to consciousness.

4. Please briefly describe your background in Jungian analysis, dreamwork or other forms of psychotherapy.

5. Have you ever been hospitalized for a psychiatric condition? Please describe. Are you currently taking medications?

6. How would you describe your health? Do you have any health problems I should be aware of?

7. Can you give a reference of someone whom you have worked or studied with (in Authentic Movement, if possible) who could recommend you? (Please include name, address, email address, and phone number)

8. Do you have any questions, concerns, or things that you want me to know about that have not been addressed? What are some of the questions that you are currently exploring in your life, work and practice?

9. How did you find out about this workshop?

Would you like to be added to our mailing list and receive periodic updates about workshops and classes?

Yes