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Client Intake Questionnaire
Fearvana Yoga New Client Questions
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* Indicates required question
Email
*
Your email
Have you done yoga before?
*
Yes
No
If yes to the previous question, how often did you go, how long ago, and if you stopped, why?
Your answer
What would you like to achieve, what are your goals?
*
Your answer
Are you currently physically active? What other sports, workouts, activities are you currently doing?
*
Your answer
Are/ Do you: (select 5 that are the most applicable to you)
*
Stressed
Stiff or tense
Inflexible & Immobile
Want to build strength
Want to lose weight
Want to learn to meditate or relax
Want to try hot yoga
Want to build endurance
Want a consistent practice
Need personal accountability
Need on-on-one coaching
Need one private yoga session to learn the basics
Want to meet others like me
Want to develop body awareness
Want to improve my mental health
Need group class setting
Required
What do you do for a living? Does this affect your body? Does this affect your mental health?
Your answer
Do you mostly sit or stand all day or a mix?
*
Mostly stand.
Mostly sit.
A good mix of both.
What is your biggest pain point right now that you hope yoga can address?
*
Your answer
Send me a copy of my responses.
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