Welcome! This is a quick get-to-know you better application for me to learn more about you. Please answer as best you can so that I can provide the best advice and support possible! (All information submitted in this form is confidential).
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I'd love to get to know you a bit better. What's your name? (first,last). *

 
Email? *

 
How did you find me? (website, referral, local class, other). *

 
Tell me a bit more about yourself. What is your # 1 current struggle, problem, pain and/or frustration you're dealing with right now? *

(i.e. back pain, stress, overwhelm, anxiety, body image, can't make it to public classes and/or want to try yoga in a safe and private environment).
 
What do you fear will happen if you don't address this pain, problem and/or frustration?

 
What is your prior experience with yoga/movement? (i.e. never done yoga before, taken privates, went to a few classes etc.) *

 
If you answered "yes" to having prior experience in yoga, what is it you liked or disliked about it? *

 
What are you currently doing (if anything) to work on your problem and/or struggle? What have you done in the past (if applicable) that DID or DIDN'T work? i.e. physical therapy *

 
What is or has held you back from reaching your goals, desires, solutions to your struggle(s)?

 
What do you hope to experience/feel/achieve by working with me? *

 
What is your deepest desire or dream you think that I can help you with?

 
What do you secretly wish was true about your current situation?

 
If you could wave a magic wand and everything was instantly perfect...What would change in your life, what would you experience/feel/do? *

 
In response to the previous question, where would your life improve?

 
What time/days during the week were you interested in scheduling in person (or skype) sessions? *

 
For fun, cause who doesn't like to have fun...If someone handed you $3000 and said to you,"go nurture yourself." "What would you do with that money?"

 
Do you have anything else you'd like to add?

 
What is the best way to contact you? (email, phone) and what time of day?

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