Medical Form

Congratulations on choosing this transformational immersion for yourself and your life.
Please take a moment to fill in your details below about your medical history, which will be strictly confidential.

Are you taking any medication?
Have you ever suffered from any of the following?

PLEASE NOTE: During EAI Retreat we will be partaking in daily yoga, somatic movement, dance, wáter dance, drumming and a long hike to one of Bali’s largest waterfalls. Although EVERY BODY is welcome to join EAI some level of physical fitness will make the immersion more enjoyable for you!