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Contact:
www.marawai.com
info@marawai.com

I have read the agreement information and am committed to the coaching process as described

I agree and am ready.

Name

First Name

Last Name

Email Address

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Telephone number

Birthdate

YYYY

Employment

Employed? Indicate in what capacity (if applicable) and your position

Relationship Status

(married, partnered, single, widowed, retired)

Do you have children?

names and ages if applicable

What led you to Mara Wai coaching?

If referred, who can I thank?

What are the issues you would like to address?

List any mind or body symptoms you would like relief from here.

Tell me a bit about your childhood and upbringing (what are the defining moments that have shaped who you are today?) Be brief: approx only 3-5 sentences

List your most defining life moments (your proudest accomplishment, your darkest moment, and whatever other benchmark moments that come to mind):

What are the areas of least satisfaction in your life?

(If possible, list your top three greatest wishes)

What dreams do you have for yourself (List your top three dreams that you would want to come into being)

What is your faith background or practice (if any)?

What else would be helpful for me to know about you before we begin?

Scheduling

Click here to schedule your session(s).

Thank you! If you wish to schedule a live session or are unable to schedule a coaching call on the dates listed in in the appointment calendar linked above, email Mara at mara.wai@gmail.com with some alternatives.

Soon after you schedule your sessions you will will receive an email invoice with payment information.

I look forward to connecting with you soon.

In service,

Mara

MINDFULNESS, MEDITATION & MIND-BODY AWARENESS

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Scheduling