Private Yoga Intake Form

1:1 Yoga Intake Form

Please complete the following form before our session.

Full Name

What inspired you to book this session?

What are you hoping to gain from our time together?

If you left our session feeling completely fulfilled, what would you walk away with?

How would you describe this current season of your life?

Which of these best describe you?

What currently gives you the most energy? Makes you feel alive, excited about life?

What consistently drains your energy?

When do you feel most like yourself? Your true self?

If money wasn't a factor, how would you spend your days?

Dosha Quiz. Instructions: Please choose the option (A, B or C) that best describes you for most of your life, rather than how you feel today. Don't overthink it. Your first instinct is usually the most accurate. We'll go through your results together during our session.

My skeletal frame is:

My bones are:

My general weight tendency is:

My skin is:

My hair is:

My teeth are:

My lips are:

My eyes are:

My nose is:

My chin is:

My fingers are:

My fingernails are:

My appetite is usually:

My perspiration/sweating is usually:

My sleep pattern is usually

My digestion/elimination is usually

How often do you eliminate faeces?

My body temperature is usually

My energy is usually:

My speech is usually

My learning styles & memory is usually

My works habits are:

My emotional strengths are usually:

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1:1 Yoga Intake Form

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