BlissEden CommUnity

Reservations

BlissEden CommUnity Guest-Patient OnBoarding Form

(1) NAME: Heaveno Beloved BlissBabe! Please Type Your Name Here:

(2) EMAIL: What’s The Best Email To Reach You?

(3) HOW MANY CEREMONIES: Number of Bliss-Medicine-Method Treatment Days?

(4) NUMBER OF GUESTS: How Many Guests?

(5) RETREAT LOCATION: Playa del Carmen or Tulum? Playa Del Carmen is Our Jungle Ceremony Base: Tulum is Available for Higher Priced Ceremonies at Guests Vacation Home.

(6) START DATE: Preferred ReTreat Start Date?

(7) END DATE: Preferred ReTreat End Date?

(8) PRE-READING: Minimium Pre-ReTreat Preparatory Reading

Yes: I Have Read The BlissEden.CommUnity Website & All ReTreat Page FAQ’s

(9) MEDICATIONS 1

Yes I Will Stop All Medications 14 Days Before My ReTreat Start Date

N/A: I Am Not On Medications

(10) MEDICATIONS 2 – Please List Your Medications and Explain Your Plan for Withdrawal?

(11) INTENTIONS: What Are Your Intentions for Your ReTreat?

(12) SOVEREIGNTY DECLARATION

Yes: I Am Self-Sovereign: I Take 100% Responsibility For My Self, My Life, & My Bliss ReTreat Preparation.

(13) MESSAGE: Please Share Anything Else Here? We Love You Earth Angel!