Personal Intake Questionnaire

Your privacy is important to us—everything you share in this questionnaire is kept strictly confidential between you and Whole Health Yoga.

This questionnaire helps your chosen yoga instructor teach and guide you within a supportive, therapeutic relationship. Your responses provide insight into your current state of health and balance—physically, energetically, mentally/emotionally, and spiritually.

We’ll use your responses to shape our first consultation and design a personalized yoga plan in partnership with you that meets your needs.

Please keep in mind this is a non-judgmental environment, where kindness toward yourself is always encouraged.

Trauma Sensitive Warning

This questionnaire has been thoughtfully created using a trauma-sensitive framework. Still, some questions about your current state of health may feel triggering. Please respond with only as much detail as feels best and safe for you in this moment. You’re welcome to respond with “no answer”, “I choose not to answer” or an appropriate response of your choice for any of the requests. If you choose additional details can be shared during your consultation call, at a pace and depth that feel right for you.