Private Yoga With Anna, Student Questionnaire

Name

Email

Phone Number

Emergency contact name & relation to you

Emergency contact phone

Please describe a typical day and/or week with regards to your work activities (including lifting, sitting, standing, computer work) and movement activities (what type(s) of exercise do you do, how often, etc.).

Please describe your current stress level, if any (we can dream, right?)

Please describe your relationship to your body—both how you’ve felt about and in it over time, and how you do now.

Please describe any health issues or concerns, such as injuries, illnesses, areas of tightness/discomfort, etc.

What do you hope to gain from private yoga sessions?

What would you like to work on in our session(s)?

Anything else you’d like me to know?

Please check below times you are generally available. We can work out the details later, including if none of these work for you.

Anything else you’d like me to know about your availability?

Private Yoga with Anna, Student Questionnaire