Intake Form
Event: Private Yoga Session
Yoga Teacher: Kelsea Spotts
Location: UM Recreation Center
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Name *
Student/Staff Email *
Emergency Contact (relation and phone number)
Have you taken yoga classes before? If yes, where and how often?
*
What style of yoga do you gravitate towards? *
What topics most align with your reasons for signing up for private yoga sessions? *
Required
Please elaborate on your reasons for seeking private yoga and what you hope to gain from the experience. (i.e. If you checked "healing from physical injury," explain what type of injury and what you hope to be able to do as it improves). *
What kind of exercise do you enjoy?
How much sleep do you get each night?
Describe your diet/ eating patterns. Do you eat regularly?
Describe yourself! What do you like to do for fun? What are your hobbies or passions? What are your studying, reading, or learning about? Do you have any dreams or ambitions? Tell me who you are to the best of your ability.
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