YOGA CONSULTATION FORM

Laura offers personalized yoga suited to meet your needs.

This form is used to understand your goals for practice, and gather information about your current physical, mental, and emotional health. All information provided on this form is confidential.

Name

First Name

Last Name

Email

Phone

(###)

###

####

Age

Pronouns

How did you discover Laura Yoga Climb?

If you are working in conjunction with a medical doctor or counselor, please provide their name and phone number:

First Name

Last Name

Phone

(###)

###

####

Do you have experience practicing yoga?

If so, please explain.

What other physical activities do you practice?

Please include things like sports, hiking, labor intensive job etc.

Do you have any past injuries or medical conditions that cause you pain or limit your mobility?

If so, please explain.

Any other feelings that you’d like to share?

Grief, Anxiety, Trauma, Insomnia, Abuse/Recovery, Stress (this can be “good stress,” such as feeling overwhelmed with school, work, planning a wedding etc.) - anything at all.

What are your goals for your yoga practice at this time?

Your goals can be physical, mental, emotional, or a combination of all three. List as many as you like.

Is there anything else you would like to tell LYCP before we start working together?

Today is the first day
of the rest of your life.

Got Questions?

REACH OUT TO LAURA

YOGA CONSULTATION FORM

Today is the first day
of the rest of your life.

Got Questions?

LAURA
YOGA
CLIMB

Prepare for class
CONSULtation form
CONTACT

YOGA CONSULTATION FORM

Today is the first day of the rest of your life.

Got Questions?

LAURAYOGACLIMB

Prepare for classCONSULtation formCONTACT

Today is the first day
of the rest of your life.

LAURA
YOGA
CLIMB

Prepare for class
CONSULtation form
CONTACT