We wish to thank you for volunteering to support this Student, and for your honest feedback.

Your feedback will be used by the senior teacher to work with the practicum student to understand their skillset as a teacher, and to support any helpful adjustments to their teaching style. Your anonymity will be protected during the review of the class with the Practicum Teacher.

If you have any questions please email us at info@lifeofwellness.ca

Name*

First NameLast Name

Email*

example@example.com

Please select your practicum teacher.*

Date of yoga class*

How long have you been practicing Yoga?*

Did the Practicum Teacher create an environment that allowed you to feel safe, where your body and autonomy were honored?*

YesNoOther

Did the Practicum Teacher do anything in particular that affected your experience?*

Did the Practicum Teacher ask you to share your medical history or request information about how to support you and your practice?*

YesNoOther

Do you feel that what you shared about you and your body was taken into consideration when guiding your practice?*

YesNoNot ApplicableOther

Did the practicum teacher share their intention for the class?*

YesNoOther

What did you understand the intention to be?*

Did the Practicum Teacher honor this intention?*

YesNoNot ApplicableOther

Explicit Informed Consent

The following definitions are to provide context for the remaining questions.

This type of consent is expected before any form of touch, adjustments, assists, or requested adaptation (individualized cues, requests, or recommendations) to a pose or practice.

Explicit Informed Consent

Explicit and Informed Consent can be given verbally, in writing, by an unambiguous gesture, or via a consent indicator.
Silence or lack of resistance, in and of itself, does not demonstrate consent.

Informed Consent

A process in which students are given important information, including possible risks and benefits, the intent of the touch, adjustment, assistance, or request.
- Without attachment to the result.
- Giving space for questions and understanding.
With the intent to help the student decide for themselves if they wish to accept or decline the request or offered suggestion.

Autonomy

The right or condition of self-government.

Here is an example:

"Would you be okay with me supporting you with some guidance for bringing balance to your experience in this pose?"

(The teach waits for your response. If you say no, your answer is honored. If you say yes, the teacher will continue with more information)

"I would like to see if aligning your knee with your ankle will support your balance in the pose. I can cue you with words or place my left hand on the outside of your right knee to give you a visual guide. I will then ask you to engage your inner thigh and press your knee towards my hand or verbally communicate for you to stop.

Then we can check in and see if you find the adjustment helpful.

How does that sound?"

(The teacher waits for your response, answers your questions, and honors your agency to stop at any time)

Did the Practicum Teacher offer any individual cues, adjustments, assists, or suggestions?*

YesNoOther

Did the Practicum Teacher gain your explicit informed consent first?

YesNoOther

Were you provided with the information you needed to understand what was being offered/suggested and the benefits and risks?

YesNoOther

Do you feel your autonomy was honored?

YesNoOther

Which of the following, if anything, impacted your autonomy?*

How I was asked or toldWanting to support the Practicum TeacherNot wanting to let the Practicum Teacher downNot wanting to or feeling uncomfortable saying noNot wanting to stand outBelieve that the Practicum Teacher knows what I need and that I should trust them over my instinctNot applicableOther

Please add any additional feedback you would like to share with the Senior Teacher about your experience.*

Please add any additional feedback you would like us to to share directly with the Practicum Teacher about your experience.*

Do you have any questions?

Would you like to learn more about Yoga Teacher Training?

Yes, please sign me up to hear more.

Confidential Student Volunteer Feedback Form

Explicit Informed Consent