Client In-Take Form Name * First Name Last Name Email * What Offering Are You Enrolling In? * Private 1: 1 Coaching The Academy of Light Bollywood Studio Dance Workout Soulful Sunday Guided Meditations Energy Healing Session Event Other What is your intention or goal for our work together? * What would you love to receive, shift, or call in during this time? Are there any mental, physical, or emotional health considerations you'd like us to be aware of to best support you? Your answer is optional and confidential. How did you hear about The Light Lounge By Jehna? Please Take A Moment to Read Through our Terms of Service and Privacy Policy * By checking the box below, you acknowledge that you have read, understood, and agree to The Light Lounge By Jehna's Terms & Conditions and Privacy Policy (found at bottom of this page). I acknowledge that insights, experiences, and messages shared during/related to our sessions may be used—anonymously and with deep respect - to inspire and inform others through promotional or educational content related to The Light Lounge By Jehna. I understand that any and all personally identifying details will be omitted or altered to protect my confidentiality, in alignment with ethical and legal standards. Acknowledged Thank you for your kindness! Here is a guided meditation as a token of my gratitude!!