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✨Private 1-1 Consultation✨
Your feedback is appreciated.
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Email
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Your email
Name
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First and last name
Your answer
Do you currently practice with me or have you ever trained with me privately?
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Yes
No
Do you have a daily Meditation practice?
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Yes
No
Do you have a daily Yoga practice?
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Yes
No
Do you have a weekly Movement/Dance practice?
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Yes
No
Are you interested in elevating your current health and wellness of mind and body?
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Yes
No
What are you seeking from working with me in a private 1-1 session?
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Your answer
Do you have an external yoga studio/gym membership?
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Yes
No
Are you using your external gym membership?
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Yes
No
Has your mental + emotional health declined since the pandemic?
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Yes
No
Please check what you most experience. Many have developed increased symptoms as a result of pandemic.
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Anxiety
Sadness
Anger
Short Temperedness
Depression
Panic Attacks
Nervousness
Fear
Cabin Fever
Not Caring / Aversion
Fatigue
Lack of Motivation
Other:
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What would be your ideal health/wellness plan for YOUR needs?
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Your answer
Would you consider working 1-1 long term to find your* specific recipe for balance?
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Your answer
Which option works best for you?
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Choose
1-1 Curated Tailored Programs for you
Monthly Subscription/ Recordings to practice at leisure
Online 1-1
In person 1-1
What is your long term vision of yourself at your best and fullest potential?
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Your answer
Do you currently have any injuries?
Your answer
Are you pregnant?
Yes
No
Not Applicable
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Anything else you would like to share
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Your answer
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