Motivation + Mindset

Full Name

Email Address

What drew you to the Elevate Her Wellness Retreat?

What outcome are you hoping for most by the end of the retreat?

What’s one area of your wellness you feel stuck in right now?

What keeps you up at night when it comes to your health or life balance?

If you could change one thing about your daily routine, what would it be?

Physical Health + Mobility

What types of movement or exercise do you currently enjoy?

Do you have any mobility limitations, injuries, or chronic conditions we should know about?

Are you comfortable with light walking, stairs, yoga, or floor-based movement?

On a scale of 1-10, how would you rate your daily energy levels?

What does “wellness” mean to you at this stage of your life?

What are your biggest sources of stress right now?

How do you typically recharge when you’re overwhelmed?

What kind of support do you wish you had more of?

Is there anything you’re currently navigating that would help us support you better — grief, caregiving, career shift, menopause, etc.?

Have you attended a wellness or educational retreat before? If yes, what did you love or not love about it?

Do you have any dietary preferences, allergies, or restrictions?

What’s your preferred learning style for workshops — hands-on, discussion-based, quiet reflection, movement?

Are you coming solo or with someone? What would help you feel most comfortable?

Is there anything else you want us to know to make this retreat safe, meaningful, and transformative for you?