* Practice history and InspirationPlease describe your practice history and inspiration for attending this program.
* Dietary restrictionsPlease tell us about any special dietary needs that you have.
* Medical conditionsWhat current or past medical or physical conditions are important for us to know about? Would any of this prevent you from doing chores during the program?
* MedicationsWhat prescription medications are you taking now—or have taken in the past six months—for physical, psychiatric, mental health, or addiction issues?
* Inpatient careHave you ever received inpatient care for psychiatric, mental health, or addiction issues? If yes, please describe:
* ConcernsDo you have concerns about engaging in intensive meditation practice at this time? Do others close to you (such as medical professionals, mental health professionals, or family members) have concerns?
* AllergiesDo you have any serious allergies (e.g. bee stings, penicillin, nut allergies, etc.)? If yes, please specify and explain how we should best respond in the event of a medical emergency.
* Hearing lossDo you have hearing loss (even mild) that sometimes requires assistance? If so please describe.
Additional Comments Is there anything else we need to know about your registration?