Private Yoga Session Questionnaire
Thank you for your interest in private yoga sessions with us at Essencia Yoga. Jeannine B. Clinton E-RYT 500, founder and head of Essencia Yoga Registered 200 and 300 hour - Yoga Teacher Training School and Wellness Center. She treasures her private sessions and finds great joy in working one on one, meeting individuals right where they are, with the needs at hand. With the increased requests coming in for Private Yoga Sessions, Jeannine has begun to work closely with a few qualified teachers, whom she is now referring practitioners to, finding great results. There are varying specialties that could make one teacher a better match than another. With over 300 hours of teaching private sessions, Jeannine has learned so much about the importance of listening deeply. In an effort to continue to learn, we have prepared a few forms to better understand our work. In order to provide you with the most personalized yoga session(s) please complete the form below to assist us in serving you better..
I will reach out to you directly to schedule our session. I am excited to work with you. If you have any questions, please do not hesitate to contact us at (**certified and insured)

Following your session, you will be asked to fill out a feedback form for the same purpose and accountability.

Email address *
First Name
Your answer
Last Name
Your answer
Email Address
Your answer
Phone Number
Your answer
What is the reason for requesting private yoga sessions? Please check all that apply.
If you are requesting a private session to deepen your practice please list any areas specific areas of the body you want to focus on and any particular poses you want to explore.
Your answer
If you are requesting a private session to address an injury or ailment please describe this injury/ailment with as much information as possible.
Your answer
What would you like to get from your yoga practice? Check all that apply
Do you have any limitations, previous injuries, or health concerns I should be aware of? If so, please explain (i.e. hip/knee replacement, slipped disc, heart issues)
Your answer
What yoga props do you have in your home?
Column 1
Yoga Wheel
Eye Pillows
Other (please specify)
Are you interested in more than one private yoga session?
Anything else you would like us to know.
Your answer
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