New Yoga Client Wellness Questionnaire
Thank you for taking the time to fill out this brief form to help me better understand your health background and wellness goals.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Do you currently practice yoga, or have you in the past? If yes, what style/type of yoga and how often do you (or did you) practice?
What aspects of yoga are most appealing to you?
increased strength
relaxation
improved flexibility
prevent injuries
breathwork
self care
Other
On a scale of 1 to 10 (10 being the most), how physically active is your lifestyle?
What other types of movement or exercise are you currently doing?
On a scale of 1 to 10 (10 being the highest), how stressful is your life/job currently?
What are your goals and expectations from your yoga practice?
Do you have any health issues that affect your mobility or are likely to cause you concern when practicing yoga? Example: arthritis, knee or hip surgery
Is there anything else you would like me to know?
Thank you for taking the time to fill out this form! Namaste
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