Name

First Name

Last Name

Subject

What type of practice are you looking for?

Please check all that apply - we can talk details later!

One-on-one live-streamed

One-on-one recorded practice

Private Group live-streamed

Private Group recorded practice

Other

Are you experiencing any of the following?

Check any that apply - we can talk details later!

Increased anxiety

Worsened depression

Pain in the shoulders/neck

Pain in the hips and/or low back

Do you have or want to build a meditation practice?

Share with us what type of music you most enjoy.

Anything else we should know about your yoga practice - things like injuries, experience level, or goals are all great to share!

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