Intake Form

Thank you for your interest in trauma sensitive yoga. I would like to find out a little more about you and what you are experiencing so I can better tailor classes to suit your needs. All information will be kept strictly confidential.

Thank you for sharing this information with me, Sonia x

Name

First Name

Last Name

Your pronouns

Phone

Email

Preferred contact method

Phone

Email

Do you have any areas in your body where you are currently experiencing physical or chronic pain? If so, please provide a brief description below

Is there anything that concerns you about joining a group yoga class?

Is there anything that you feel might be a trigger for you in a yoga class (i.e. certain postures/movements, conscious breath practice, smells/sounds etc)?

What are you hoping to get out of these classes?

Have you practiced yoga before?

Yes

No

... And lastly, how did you hear about these classes?