Private Yoga Session Info & Appointment Request Form
Hi, I'm Anna. I look forward to working with you to meet your goals of private yoga instruction through poses (asana), breathing exercises (pranayama) and meditation. Please answer the following questions to help me better understand your interests, abilities, goals, availability, and anything else you would like me to know!
Full Name
*
First Name
Last Name
Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Would you like to inquire about private yoga for a single person, or two people? If two people, please have the second person also complete a form.
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Single Person
Two People
If you are interested in a two person private yoga session, what is the name of the second person?
What days of the week and times work best for you for a one hour session? How soon would you like to schedule?
Do you have any experience practicing yoga? If you have practiced yoga, what types of yoga have you practiced?
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Vinyasa/ Hatha Yoga
Hot / Bikram / Power Yoga
Yin Yoga
Restorative Yoga
Ashtanga
Kundalini
Yoga Nidra
Other
How many hours per day do you spend sitting (at a desk, in the car, etc.)?
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0 - 2 hours
2 - 4 hours
4-6 hours
6 - 8 hours
8+ hours
What is your occupation?
What types of physical activity do you practice now, and how often?
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What is your current stress level?
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None to Low
Average
High
Off the charts
Do you have any current or previous injuries, illnesses, health conditions, recent surgeries or fractures that may affect your practice or would be important for me to know? What are they and when did they occur?
*
Please share your goals and any expectations for private yoga sessions. What benefits do you hope to gain from our private yoga session?
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Are you comfortable receiving hands on pose assists or guidance?
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Yes
No
Other: there are areas you should avoid touching, but unlisted areas are okay to receive hands on assists. List the part(s) of the body to be avoided/ not touched in the next answer.
List the areas of your body that should not be touched (pelvic area and chest will never be touched through hands on assists.)
Do you have any specific requests for poses, breath work, music, or themes of our private session?
Is there anything else you would like me to know?
How did you hear about Yoga Sounds/ Anna Bowers, Registered Yoga Teacher's private yoga sessions?
Facebook
Instagram
Friend/ referral
Google
Middle River Yoga
One Love Mind Body
R&R Healing Co.
Would you like sound healing to be incorporated into the private yoga session? This would happen during savasana, or final resting pose of class.
Are there any services or workshops you would like to see offered?
Would you like to sign up for Yoga Sounds' newsletter to learn about promotional services and upcoming events?
Yes
No
Signature
*
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