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Taoist Yoga New Client Form
Thank you for taking the time to complete this form. Please be as specific as possible. Thank you!
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Email
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Your email
First and Last Name
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Your answer
Phone Number
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Your answer
What services would you like to book?
Thai yoga session - 90 minutes ($110)
Elemental Consultation with protocol follow-up - 45-60 minutes + 30 minutes ($85)
Private Yin Yoga Lessons - 90 minutes ($85)
Reiki - 30 minutes (add-on only)/60 minutes ($30/$75)
Make my own package (15% discount - please specify below)
Other:
Have you done yoga or had bodywork previously?
Yes
No
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Are you experiencing physical pain or injury? Or have past injuries to be aware of? Please describe.
Your answer
Are you or have you experienced particular traumas that I should be aware, such as intimate partner violence, addiction, abuse, PTSD?
Your answer
Are you or have you experienced ongoing emotional disruptions, such as rage, depression, anxiety, or terror that hinder your well-being?
Your answer
Are there familial, collective, or epigentic traumas, such as structural violence by class, race, gender, ability, and/or sexuality, that you want me to be aware of?
Your answer
What do you hope for in our work together? What are your goals?
Your answer
How's your spiritual, emotional, and physical health?
Your answer
Are there particular questions or concerns I can address?
Your answer
A copy of your responses will be emailed to the address you provided.
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