Private Yoga Session Intake Form

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Thank you for your interest in Private Yoga Sessions with Sandra Russi, E-RYT, RScP. Sandra is a certified Ananda Yoga instructor and certified multi-style instructor with over 23 years of teaching experience. She is registered with the Yoga Alliance as an "Experienced Yoga Teacher" with over 7,000 teaching hours. In addition, she is a licensed Practitioner of the Science of Mind, leads a local meditation group, and is known for her clear, gentle instructions. She focuses on safety and comfort first, modifying postures as needed to work with your body, and will customize a program to help you achieve your personal goals.

Private Session Fees begin at $95/hour or $135/1.5 hour session. Add $20 for additional person. Packages of 3 sessions or more are available at a discount. Depending on location, there may be a surcharge for travel.

To begin, complete the form below. Reach out to Sandra with any questions at sandi@eastsacyoga.com or 916-606-0799.

Email *

Email address *

First & Last Name *

Phone Number *

Will anyone else be participating in the private yoga sessions? If so, enter name(s) below. *

Indicate your desired location for the private sessions: *

My home

Instructor's location

Other:

If lessons are held in your home, will any non-participants be present? *

Yes

Maybe

If your home is the desired location, please provide your address, including zip code.

What is your general experience level with yoga? *

0 - 6 months' experience

6 - 12 months' experience

1-3 years

4 or more years

Do you have a meditation practice? *

Yes

Somewhat or off & on

Check your reasons for requesting private yoga sessions. Check all that apply. *

I am a beginner and want to practice in a one-on-one comfortable environment.

I am an intermediate level and want to deepen my practice and learn advanced postures.

I cannot find any suitable group classes in my community that fit my needs.

I need guidance practicing safely due to a medical condition or prior injury.

I want guidance with not only the physical aspects of yoga, but also the non-physical and/or spiritual aspects of yoga.

Other:

Required

Below, you may further describe any specific areas you want to explore or work on, whether physical or non-physical.

If you have an injury or ailment, describe with as much information as possible. Include any physical limitations or medical advice from your provider regarding physical activity.

Check any and all areas below that you are particularly interested in. *

Muscle Strength

Joint Stability

Improve Posture

Healthier Lifestyle

Improve Sleep

Spiritual Growth

Yogic Philosophy

Flexibility

Increase Body Awareness

Improve Mindfulness

Improve Breathing

Reduce Stress/Anxiety

Increase Sense of Inner Peace

Deep Relaxation and/or Yoga Nidra

Meditation

Yoga Nidra

Other:

Required

What yoga props do you already have in your home? Check all that apply. *

Mat

Blocks

Bolsters

Straps

Eye Pillows

None

Other:

Required

How many private yoga sessions are you interested in? *

1-3 sessions

4-6 sessions

7-10 sessions

More than 10 / ongoing

Indicate the desired length of each session

1 hour

1.5 hours

Other:

Clear selection

Use the space below for any additional comments, questions or concerns you may have.

Send me a copy of my responses.

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