Thank you for your interest in booking a private yoga session!  I look forward to working with you.  Please complete this intake form, and if we have yet to schedule our first appointment I will contact you soon.  If you have any questions, e-mail me at kate@yogarefugepdx.com.
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What's your first name? *

 
Hey {{answer_20599712}}, nice to meet you.

What is your last name? *

 
What is your birthday? *

 
What is your occupation?

 
What other hobbies or common activities are a part of your life?

 
I currently offer 2 primary services: Private Yoga Therapy and Life Coaching. Depending on my client's needs, I can work exclusively in one modality or the other, or I can blend the two. Please let me know what you are most interested in. *


 
Do you have any previous experience with yoga, and/or coaching?  Please elaborate. *

 
How would you describe your physical well-being at this stage of your life?  Is there anything you would like to change or improve?

 
How would you describe your mental/emotional well-being at this stage of your life?  Is there anything you would like to change or improve?

 
Do you have any injuries, illnesses or chronic issues that are currently relevant to your life?  If you are working with a specific diagnosis, are there physical movements or poses that you have been advised to avoid by a medical or wellness professional?  Please elaborate.

 
How would you describe your creative, vocational or spiritual alignment at this stage of your life?  Do you feel fulfilled in these areas?

 
In my work, I draw from my extensive knowledge of yoga asanas (the poses), anatomy and alignment, mindfulness/meditation and breathing exercises, as well as Ayurveda, yoga philosophy and the contemplative wisdom traditions.  I also have a masters degree in Contemporary Performance, and I am passionate about the intersection of creative process and contemplative practice, and I am a trained life coach.  Below I will list several common reasons why people come to see me.  I would love to know what your main goals for our work together are, and what you would be open to trying.  Please select as many of these as feel interesting and relevant to you in our work together. *


 
Is there anything else you would like me to know as we enter into our work together?

 
I currently offer different packages for private clients.  Please select the one that you would prefer.  (please note, pricing options are slightly different for couples or groups). *


 
I see clients Tuesday through Saturday.  Please select all of the times that could work for your schedule, and I will contact you with my next availability during your selected times.  If you become a long-term client, I can sometimes accommodate other times of the day/week when needed.


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