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Lausten Sound
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Intake form
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Name
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Email address
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What services are you interested in?
Please select at least one option.
Crystal Bowl Healing
Drumming
Massage Therapy
Yoga Nidra
Have you received sound healing or massage therapy before?
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Yes
No
What are your primary goals for this session?
Do you have any medical conditions or injuries we should be aware of?
Preferred session length
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30 minutes
60 minutes
90 minutes
How did you hear about us?
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Referral
Social Media
Search Engine
Event
Which service or services are you interested in?
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Additional questions or comments
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