Yoga Clients Intake Form

Client Information:

• Full Name:
• Date of Birth:
• Phone Number:
• Email Address:
• Address Line 1:
• Address Line 2:
• City:
• State:
• Zip Code:

Yoga Experience:

• Have you practiced yoga before?:
• If yes, how long have you been practicing yoga?:
• What are your main goals or reasons for practicing yoga?:

Health Information:

• Do you have any injuries or health conditions we should be aware of?:
• If yes, please provide details:
• Are you currently taking any medications that might affect your yoga practice?
  Yes
  No
• Are there any specific areas you would like to focus on or avoid in your practice?:

By completing these fields accurately, you provide essential information that helps us tailor our services to meet your individual needs.