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Wellness Retreat Request Information
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» Wellness Retreat Request Information
Wellness Retreat Request Information
Please fill out the following information.
Contact Information
*
Guest 1:
*
Guest 2:
Mailing Address:
City:
State:
Zip Code:
*
Email Address:
Primary Phone Number:
Secondary Phone Number:
From (arrival):
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Year
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To (departure):
Day
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2008
2009
2010
Wellness Immersion Packages
Which wellness immersion package best meets your needs?
3-Day Silver Package
3-Day Gold Package
3-Day Platinum Package
5-Day Silver Package
5-Day Gold Package
5-Day Platinum Package
7-Day Silver Package
7-Day Gold Package
7-Day Platinum Package
We are here to guide you on a path to healthier living.
What is/are your health goal(s) for your wellness immersion retreat?
(check appropriate box):
Cleanse & purify
De-stress
Eat healthier
Feel more energized
Gain muscle
Have fun and play
Improve the quality of my relationship(s)
Increase cardiovascular endurance/health
Increase romance with my partner/spouse
Learn effective stress management techniques
Learn how to incorporate a more active lifestyle
Learn meditation
Learn more about natural therapies
Learn new ways to prepare food
Learn to be a fit and fabulous senior
Learn to prepare living (raw) foods
Lose weight
Recover from childbirth
Recover from surgery/illness
Relax and unwind
Socialize and make new friends
Strengthen my immune system
Wellness Options
Please choose from the following services in which your are interested
(check appropriate box):
Nutrition & Living Foods
Living Foods Preparation
Gourmet Vegetarian Cuisine
Smart Grocery Shopping Class
Private Consulation with Dietician
Grocery Shopping with Dietician
Preventative & Integrative Medicine
Acupuncture
Women's Health Classes
Learning about Herbs and Herbal Therapies
Ayurvedic Medicine Classes
Private Consulation with Naturopathic Doctor
Private Consulation with Integrative Medical Doctor
Beauty
Alpha-hydroxy Peel
Dermaglide Exfoliation
Eminence Organic Facial
Express Facial
Men's Facial
Treatment Facial
Vitamin C Facial
Physical Wellness
Group Exercise Classes
Personal Training Sessions
Therapeutic (Body Treatments)
Eminence Organic Body Masque
Herbal Stimulating Mud Treatment
Herbal Tea Body Wrap
Mint & Honey Body Dip
Polish & Tan
Salt Glow
Therapeutic (Massage Therapy)
Hot Stone Massage
Aromatherapy Massage
Couples' Massage
Deep Tissue/Sports Massage
Deep Tissue/Sports Massage with Hydrotherapy
Head & Shoulders Massage
Prenatal Massage
Reflexology Massage
Swedish Massage
Spiritual Wellness
Meditation Class
Special Instruction and/or Comments
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