Thank you for your interest in private yoga sessions. Tell me more about you by filling out this information form. I will be in touch within 3 business days to schedule your complimentary phone or Skype consultation.
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Your full name *

 
Address, including city, state & zip *

 
Phone number *

 
Birthdate (month/day/year) *

 
Occupation *

 
Hobbies *

 
Why are you interested in private yoga? What goals or issues are you hoping to address? *

 
Describe your current yoga practice, if any.  (It's okay to be a beginner!) *

 
Describe any injuries or chronic conditions that could affect your practice. *

 
Do you have pain in the body? If yes, please indicate where and describe the pain. *

 
On a scale from 1 to 10 (with 1 being low and 10 being high) how would you rate your level of stress.  What are the biggest factors affecting your level of stress? *

 
To see the greatest benefit from our sessions it is important that we meet at a regularly scheduled weekly time and that you practice your homework between sessions. Will your schedule allow you to set this time aside? *

 
How did you hear about my work?

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