Select a program date: January 25, 2016
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Select a Retreat: October 9 - 11, 2015
Prior yoga experience: NoneFew classesLess than 1 year1-2 Years2+ Years
Current Age: Do you have children now? Yes No
Are you currently receiving any treatment related to fertility issues?
Yes No Not currently, but within the past 12 months
If yes, who is treating you?
If yes, please explain briefly the treatment:
Do you have any injuries I should know about?
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Women’s Fertility Retreat
Mind/Body Program for Fertility
January 25 - March 28, 2016