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LOV Yoga Intake Form
Please fill out this form as you honestly feel in this present time in life. The *required fields are helpful in planning your yoga therapy session. Please reach out to tara@lov.yoga with any questions. Thank you for your time, I look forward to working together! 
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Name *
Email *
Phone
Date of Birth *
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Emergency Contact *
What are your goals for yoga therapy? (please include 2 - 3)  *
How much time can you dedicate to your yoga practice each week? 
How do you hope to feel after a yoga therapy session?  *
How are you feeling physically? Explain any injuries, tension, stress and/or chronic pain in your body.  *
What movements are difficult, painful or ones you have been told to avoid by a medical professional?  *
What injuries, surgeries or other major trauma has occurred to your body in the past 10 years?  *
What supplements and/or medications are you taking? 
How do you relieve stress? 
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Have you suffered a major loss in the past 10 years that caused grief? 
What is your normal sleep routine? How many hours per night do you sleep? Do you struggle with sleeping regularly? 
What life challenges are you currently facing? 
What brings you joy? 
If you could change one thing about your current life/routines, what would it be? 
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