Private Yoga Session Intake Form

Private Yoga Intake Form

Thank you for taking the next step to take care of your body, mind, and soul. Please take a moment to fill out this form in preparation for your session and complete it 24-hours prior. I look forward to working with you.

Everything shared in this form and in our sessions is confidential. If you are being harmed, plan to harm someone else, or plan to harm yourself, I am required by law to break confidentiality to make sure you get the help you need.

First Name

Last Name

Email Address

Mailing Address

Phone number

Birthday

How did your learn about beYou with Rachael?

What are your goals for a private yoga session?

What is your previous yoga experience, if any?

Please tell me about any injuries you have had and/or are currently dealing with. Do you have any physical limitations? Describe how these injuries impact your yoga practice.

What do you do for work? Please describe your work space set up. Do you have any physical challenges or discomforts with the way you work?

What are the current stressors in your life? What would you like to change?

What brings you joy?

Is there anything else you would like to tell me about?

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Private Yoga Intake Form

“I knew during my first yoga class with Rachael that I found my match. Rachael reminds me to breathe in my intentions and to breathe out gratitude. This helps me stay balanced during the day and I feel I sleep better at night.” ~ Loreen H, San Francisco (CA)

“I knew during my first yoga class with Rachael that I found my match. Rachael reminds me to breathe in my intentions and to breathe out gratitude. This helps me stay balanced during the day and I feel I sleep better at night.”

~ Loreen H, San Francisco (CA)