MBSR Waitlist with Naomi Nurgitz

Our ONLINE Meditation-Based MBSR program is modeled on the Stress Reduction Clinic created by Jon Kabat-Zinn PH. D at the University of Massachusetts Medical Centre in 1979.

What are the benefits of Mindfulness?
Mindfulness is the practice of present moment, open-hearted awareness of one's life experience. It starts with practices which befriend the body/mind. Many people find it helps them:
• Flourish by enhancing physical, emotional, mental, and social health and well-being,
• Deal better with the tough stuff: Be less reactive to stress, difficult emotions, situations, and people in your life,
• Develop practical skills to apply kindness and understanding to oneself, others, and the world,
• Find joy in everyday experiences.

Course Details
Facilitator: Naomi Nurgitz (905) 884-6706 naomi@mindfulnesseverday.org
We are interested in whether you would attend in-person or online? During the day or the evening? Weekday or Weekend?
Let us know your thoughts.....
Name Name * First Last
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email *
Preferred Phone Preferred Phone * - ### - ### ####
What gender do you identify with? *

What gender do you identify with? Male Female Other Other
Age *

Age 0-25 26-35 36-45 46-55 56-65 65 plus
Do you have any physical requirements
that we should be aware of?

Do you have any physical requirements
that we should be aware of? Accessibility Allergies Any other requirements? Any other requirements?
Before teaching mindful movement (which is an integral part of the MBSR Program), we want to get to know any physical limitations you might have so we can keep you safe.

Here is a list of common physical limitations. Please check the ones that apply to you. You are not alone.

Before teaching mindful movement (which is an integral part of the MBSR Program), we want to get to know any physical limitations you might have so we can keep you safe.

Here is a list of common physical limitations. Please check the ones that apply to you. You are not alone. Lower back pain • Osteoarthritis of the back • Osteoporosis/osteopenia Carpal Tunnel • Arthritis in the wrist/fingers Shoulder/Rotator Cuff injuries • Frozen Shoulder • Bursitis/Tendonitis of Elbows or Shoulders Knee injuries • Arthritis in the knees Glaucoma • Eye infection Pregnancy • Hernia • Abdominal Surgery Prone to headaches • Migraines Dizziness Ankle injury • Arthritis in feet
Referral Source:

Referral Source: Mindfulness Everyday Website Mindfulness Everyday Newsletter Social Media Colleague Other Other
Please tell us about any mindfulness/meditation/yoga training you have had, including any retreats that you have attended
I there any other information that you’d like us to know that may affect your ability to fully participate in this workshop.