Name

First Name

Last Name

How often do you meditate?

Why have you decided to learn to meditate?

What type of meditation have you practiced (if any)?

e.g. Mindfulness, Vedic, TM (Transcendental Meditation) etc

What has stopped or limited you from learning meditation in the past?

What are you hoping meditation will do for you?

What relaxes you the most?

Listening to music

Watching a movie

Getting a massage

Going for a run

List any medication you are taking (optional)

e.g. anti-depressants etc

Do you have any questions about meditation for Luke before your first session? If so, ask below: