Welcome! - 1:1 Yoga Intake Form
Every private session is tailored to your unique needs, whether you're seeking greater strength and flexibility, healing from stress or burnout, recovering from injury, or simply longing to feel more grounded in your everyday life. My intention is to create a supportive space where you can slow down, listen inward, and leave each session feeling more connected to your body, your heart, and your authentic self.
If you haven't already, I highly encourage you to read about my style of yoga and intentions before filling this form out. You can read about my intentions and style here.
Please provide 3 dates and times that would work best to meet over zoom after this form is complete to determine if this is a fit.
This questionnaire is meant to help me understand your goals, health history, movement patterns, preferences, and intentions so we can create a safe and personalized experience.
What are your primary goals? (Check all that apply.)
Have you practiced yoga before?
SECTION 3- Health History
Do you experience pain in any of the following? (Please check all that apply)
Have you ever been diagnosed with any of the following?
(Please check all that apply)
How active are you currently?
SECTION 4 - Stress & Wellness
How would you describe your overall energy level
SECTION 5 - Your Practice
Which aspects would you like incorporated into your sessions? (Please check all that apply)
How physically challenging would you like your practice to be?
How often would you like to practice together?
Preferred Way to Practice
I understand that yoga is a complementary wellness practice and is not a substitute for medical care. I agree to listen to my body, practice within my own limits, and inform my instructor, Madleen LLC of any discomfort, injuries, or health changes before or during each session. I understand that participation is voluntary and I assume responsibility for my own well-being throughout the practice.
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