Private Yoga Client Form

1

Name* This field is required.

First Name

Last Name

2

Phone Number* This field is required.

Please enter a valid phone number.

3

Are you new to yoga?* This field is required.“New” means 5 or fewer classes

YESNO

4

Why are you interested in one-on-one sessions?* This field is required.Select all that apply

Gain confidence to go to larger classes

Tailor a practice to my specific needs

Have a space to ask questions

Convenient schedule

Goal-oriented: there is something specific I’m working on

I like privacy

Something else

5

Are you working with any health conditions or limitations that may impact your practice? If yes, please list below. * This field is required.Otherwise, type "no".

7

What time frame(s) work best for you?* This field is required.We will narrow down a specific time later

8 AM - 11:30 AM

12 PM - 3:30 PM

4 PM - 7:30 PM

8

Is there anything else you would like me to know?* This field is required.