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Set Up for Success Assessment
Thank you for choosing Peace through Yoga! As a boutique yoga studio located in the heart of your neighborhood, we love knowing our students and want to get to know you too! You won't get lost in our classes, you won't be a number. We care and want to support you for any reason that originally brought you to our studio. Thank you for taking a few minutes to complete our assessment. We are off to a great start!
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Full Name
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Your answer
Email
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Your answer
Phone [mobile]
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Your answer
How did you learn about Peace through Yoga?
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Drive/Walk by
Referral [please share who referred you so we can say "thank you!"]
Google search [yoga near me or similar search]
Facebook
Instagram
Picked up a flyer
A silent auction at an event
Other:
If another student referred you to us, please share that student's name.
Your answer
Before coming to Peace through Yoga, had you done yoga before? And if yes, why did you stop?
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Your answer
Which studio are you most likely to visit? You may select more than one.
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Speedway
Danville
Franklin
Required
Why are you interested in developing a yoga practice?
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Your answer
How frequently would you like to take yoga classes?
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1-2x/week
3-4x/week
5 or more times/week
Infrequent and irregular use - less than 4x/month
Other:
Everyone has the potential for something to stop them. What do you think may be your biggest obstacles in practicing yoga regularly?
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Time
Budget
Uncomfortable entering a yoga studio
Schedule conflicts
Lack of skill or understanding
Family commitments
Injury
Other:
When is it most convenient for you to take classes?
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Early Mornings [weekdays before 9 am]
Mid-mornings [weekdays 9 am-noon]
Mid-afternoon [weekdays noon-5 pm]
Evenings [weekdays after 5 pm]
Weekends before noon
Weekends after 4 pm
Other:
We all need someone in our corner. Who is in your support system? Will they cheer you on so you stay strong?
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Your answer
Please describe any medical conditions, injuries, surgeries and chronic pain that may inhibit your practice. Poses can be modified and we want to be sure to help you practice safely.
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Your answer
How long has it been since you were last in your ideal shape?
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Your answer
On a scale of 1 to 5, how committed are you to improving your health and maintaining a regular yoga practice?
Not too committed
1
2
3
4
5
Extremely committed
Clear selection
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