Guest Experience Intake Form

Retreat Pre-Arrival Information - Fill in as soon as you book your flights.

We look forward to welcoming you to The Jenesis House. Please share some details about yourself so that we may provide a truly personalized experience. Best to fill in after you have booked your flights.

If you have multiple guests in your reservation, please be sure each individual completes this questionnaire separately.

First Name

Last Name

Phone Number

Mailing Address

Emergency Contact Name

Emergency Contact Phone Number

Booking Reservation Number

Retreat Location & Date

Are you traveling with another guest? If Yes, please add name below if NO please put N/A

Have you been fully vaccinated against COVID-19?

Do you plan to enjoy any wellness, spa and/or healing arts activities during your stay with us?

Our culinary program offers primarily plant-rich meals, often served alongside local seafood (may include shellfish or fish) or poultry (may include chicken, duck, quail or other poultry). Please inform us of any allergies or dietary restrictions.

Airline Name Arrival

Flight Number Arrival

Date of Arrival

Time of Arrival

Airline Name Debarture

Flight Number Departure

Date of Departure

Time of Departure

Please confirm airport code for retreat arrival.

Any Health Concerns we should know about?

Are you pregnant?

May we ask how you heard about The Jenesis House?

Is there anything else you would like us to know?

Guest Experience Intake Form

Retreat Pre-Arrival Information - Fill in as soon as you book your flights.

Thanks for submitting!

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