Mindfulness Sessions Manager Request Form

Congratulations on taking another step toward supporting your team! Research demonstrates that practicing mindfulness can improve resilience and well-being. Hosting a mindfulness session for your department is a great idea and we are here to help you!

Answering the next few questions will help us design a program to best meet your department goals.

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* 1. How many people do you expect to attend?

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* 2. Will this be in-person or virtual?

In-person is the most effective

Virtual

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* 3. Please provide at least three possible dates that your team would be available.

Date #1

Date #2

Date #3

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* 4. This session is 30-45 minutes long. Does that timeframe work with your agenda?

Yes

If not, please list your time constraints or needs here.

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* 5. We find the session is most successful if it is conducted at the top of your meeting as it will add value to the rest of your meeting objectives. Does this work for you?

Yes

No

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* 6. Please list the most pressing needs of your staff right now.

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* 7. As the group leader, how do you think mindfulness can help your team?

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* 8. Please share any additional details that would help us build a tailored mindfulness session for your team.

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* 9. Please provide us your contact information.

Name

Department

Contact Email

Contact Phone Number