Meditation and Mindfulness Retreat Pre-Screening Form

Meditation and Mindfulness Retreat Pre-Screening Form — Form Fields

This events template includes 9 fields. Pre-screen retreat participants for health readiness and intention setting. Free to customize and use on ZenBuild.

• Full Name (text, required)
• Email (email, required)
• Meditation Experience (dropdown selection, required) — options: None, 1-6 Months, 6-12 Months, 1-3 Years, 3+ Years
• Retreat Type (dropdown selection, required) — options: Weekend Silent Retreat, Day Retreat, Online Retreat
• Practices You've Tried (checkboxes, optional) — options: Mindfulness (MBSR), Vipassana, Transcendental, Loving-Kindness, Yoga Nidra, Breath Work
• Currently Under Mental Health Care? (multiple choice, required) — options: Yes, No
• Intention for Attending This Retreat (long text, required)
• Any Physical Conditions Affecting Seated Practice? (multiple choice, required) — options: Yes, No
• Physical Limitations Details (if yes) (long text, optional)