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Trainee Intake Form
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Name
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DOB (DD/MM/YY)
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Email
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Phone Number
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Address
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Line 1
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City
State
Zip Code
Country
Emergency Contact ( Name / Phone)
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Occupation
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Hobbies/Activities/Interests
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Are there any weekends or sessions you are unable to attend? If so please list below
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Are there any accommodations or support you may need in order to feel supported in this learning environment?
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Yoga Experience
How often do you practice yoga?
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Nearly everyday
2-4 times per week
Once per week
A few times per month
If other please specify
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What styles of yoga do you normally practice? (Check all that apply)
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Ashtanga
Vinyasa Flow
Restorative/Gentle
Yin
Iyengar
Power/Hot
Bikram/Hot
Hatha/Strong
What are your interests regarding yoga? (Check all that apply)
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Asana (Physical Practice)
Pranayama
Meditation
Yoga Philosophy
Energetic Anatomy (Subtle Body, Chakras/Etc)
Physical Anatomy
Lifestyle & Fitness
What is your current level of fitness
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Very Inactive
Fairly Inactive
Average
Fairly Active
Very Active
On a scale from 1- 10 (1 being the lowest) how would you rate your level of stress?
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1
2
3
4
5
6
7
8
9
10
What activities or actions do you do daily that could benefit from more flexibility or strength?
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Daily work or leisure activities/ sports or other exercises
What activities or strategies, if any, do you utilize to combat stress?
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SUBMIT
Home
Philosophy
Offerings
Ongoing Programs
Workshops & Events
Private & Semi-Private Classes
>
Private Lesson Intake form
OB Shuttle Private Sessions
Blog & Updates
Our Team
Yoga Teacher Training
2019 Fall YTT Students
Podcast