Admission Questionnaire

Evoking Inner Healing Retreat

Dear Participant,

Through this comprehensive intake form, we aim to get an optimal understanding of your experienced symptoms, health, and well-being before you begin the program.

Completing the full intake questionnaire will take approximately 30-45 minutes.

It's important that you are aware that final participation in the retreat is only
possible after completing and returning info@dokterdecock the medical form and after
completing the medical intake to rule out any contra-indications before the retreat.
After receiving your completed medical form one assigned team member will contact you by
email to book an intake date and time. This assigned team member will be your mentor for
the whole journey. The intake will take 1 - 2 hours by zoom or other video conferencing
modality.
The official payment will only take place after the medical intake has been approved.

Thank you,
Team Evoking Inner Healing Intelligence // Able