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Private Sessions: Intake Form
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* Indicates required question
Name
*
Your answer
Location
*
Your answer
Phone
*
Your answer
Email
*
Your answer
Describe your experience with yoga/ meditation
*
Your answer
Have you done yoga/meditation before?
If so, how often, what style and experience level?
*
Your answer
What are your goals and expectations for private yoga/ meditation sessions?
*
Your answer
Preferred Styles and Interests
*
Hatha
Gentle
Yin
Restorative
Chair
Breathwork
Meditation
Other:
Required
How many people will participate in your class?
*
Your answer
List relevant medical history including injuries, surgeries, physical or mental health conditions that i should be aware of:
Your answer
How did you hear about me?
Your answer
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