Kismet Healing Arts - Yoga Intake Form
Thank you for letting me join you on your yoga journey! 
This form is designed to help me know a bit more about your current relationship with yoga and your body, as well as your goals for our sessions.
For questions or concerns, email: kismethealingarts@gmail.com. 

Thank you!
Zee Parker, LMT, CYT (they/them)
(206)819-7205
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Email *
Legal First and Last Name *
Preferred Name
Pronouns
Please list all injuries, surgeries, and approximate timeframe. *
What are your problem areas?
Which movements are difficult? *
What does your physical activity look like during a typical week?
What are your goals & hopes for these sessions?
What are your worries & fears in regards to this practice?
How long is your ideal yoga session?
Are you interested in meditation?  
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Do you prefer a purely scientific approach or are you down with the woo? For the sake of vocabulary, what, if any, are your spiritual beliefs? (It's ok to leave this blank!)
Are you interested in learning yoga philosophy and history?
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Would you like cues & assists to be verbal or physical? Or a combination? (You can always let me know the day of the session if you don’t want to be touched that day.)
Clear selection
What kinds of classes are you interested in?
What areas of town would you like to see classes happen in?
Do you have any other questions or concerns?
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