Sierra Lopez Yoga: Client Intake Form

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Name & phone number *

Home address & any parking instructions *

Emergency contact (name & phone number) *

Where will we be practicing? *

Living room

Home gym

Patio

Other:

Will any furry friends be joining us? (I love them, I want to ensure I don't bring any props they are allergic to!) *

Yes

Other:

Experience level *

First time

Beginner

Intermediate

Advanced

Goal(s) in mind for the session(s) *

Are there any injuries or sensitivities I need to know about? *

What kind of music vibes are you looking for? *

Lo-fi/Chill

Acoustic/Soft

Meditative/Nature

Upbeat/Rhythmic

Other:

I provide everything. Please check all that you need: *

Mat

Blocks

Blanket

Strap

Boulster

Required

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