MelMarie Studio Consultation
Fill out the following intake form. This intake is designed to inform Mel on giving yoga therapy protocols, practices, and suggestions on where to begin providing a more customizable approach on your self care needs through our Virtual Studio. Once completed, within 1-2 days, Mel will send you a voice message either through text or Voxer based on your consultation.

Note: For iPhone users- you will receive a voice text message and are welcome to correspond there. For other phone users- please download Voxer search @melmarieyoga and send "Consult" to receive your complimentary self care consultation.
Sign in to Google to save your progress. Learn more
What is your First and Last Name *
Which Phone do you have- this determines how Mel will reach you. *
What is your phone number? *
Have you practiced yoga before? *
Have you practiced mindfulness and/or meditation before? *
Please share your current self care routine or practices. *
What are you hoping to nourish, address and receive through MelMarie's Virtual Studio? *
Do you have any physical injuries, recent surgeries or health challenges? *
Are there specific challenges or aspects of mental health you are navigating and looking to nourish? *
Select all of the following that interest you the most. *
Required
Is there anything else you want Mel to know? *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms