Private Session Intake Form

Please fill out the Client Intake Form before your first class and return for review at least 48 hours prior to your first class. Your data will be treated confidentially and housed securely. This form is voluntary; it helps me teach you properly. All information is not mandatory to attend class.

Personal Information

Lifestyle & Fitness

How would you rate your current level of activity? (check one)

Yoga Experience/Goals/Interests

Have you practiced yoga before

If you have a current yoga practice, how often do you practice

Style(s) of yoga practiced most frequently: (check all that apply)

What are your goals/Expectations for your yoga practice? What benefits are you looking for? (check all that apply & explain)

Personal Yoga Interests: (check all that apply)

State of Health

Check any of the following symptoms, past or present:

Are you pregnant

PLEASE READ THE FOLLOWING INFORMATION AND SIGN BELOW:

I am humbly delighted to have you as a Paris Yoga Project client. The following information will help you get the most out of your yoga classes and clarify our instructor/student relationship.

I believe that Yoga is more than just a physical exercise, It is a transformative practice that integrates body, mind and emotional tensions to arrive at deeper levels of relaxation and awareness. All exercise programs involve a risk of injury. It is highly recommended that you consult your physician prior to beginning this or any other workout/physical activity. By choosing to participate in yoga classes, you voluntarily assume a certain risk of injury.

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Being aware and connected to your body is a fundamental to the practice of Yoga. I understand that yoga includes physical movements as well as an opportunity for relaxation, stress re-education and relief of muscular tension. As is the case with any physical activity the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. If I experience any pain or discomfort, I will listen to my body, discontinue the activity and ask for support from the instructor. I agree to inform my yoga instructor of any activities or movements, which I feel could cause injury to myself.

Yoga is not a substitute for medical attention, examination, diagnosis or treatment. I understand that no medical diagnosis will be given and no promises of cure have been made. By attending this class I affirm that I am solely responsible for my health and well-being, as well as my decision to practice yoga, a program of physical exercise. I understand that yoga is not safe under certain medical conditions. I do no have any physical conditions or disability that would limit my participation or preclude an exercise program. I assume full responsibility for any and all damages, which may incur through participation. If I am pregnant, become pregnant or I am post-natal or post-surgical, my signature verifies that I have my physician’s approve to participate. Paris Yoga Project and its instructors shall not be held liable for any injury, loss or damage to property and/or persons sustained during or as a result of participation in this class. I agree to listen to my body and monitor myself during every session.