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5-Day MBSR Tools Summer 2018

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5-Day MBSR Tools Information Form Summer 2018

Health Information

Please take a moment to respond to the following questions.

Please list three personal goals you have for taking the MBSR Course.

Informed Consent Agreement

The risks, benefits and possible side effects of the Stress Reduction Program were explained to me. This includes skill training in meditation methods as well as gentle stretching (yoga) exercises. I understand that if for any reason I am unable to, or think it unwise to engage in these techniques and exercises either during the sessions at Ramapo College or elsewhere, I am under no obligation to engage in these techniques nor will I hold the above named facility liable for any injury incurred from these exercises. Furthermore, I understand that I am expected to attend all 5 daylong sessions and to practice assignments given during the duration of the training program.

Email Communication Consent

As a participant in the Stress Reduction Program, you may wish to communicate with your instructor via email on occasion. In order to ensure your privacy, we request that you give written permission for this form of correspondence.
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