Intake Form — Lindsay Majer Yoga

I look forward to working with you!

Please complete the following form so I can learn more about you and tailor our session to meet your needs.

Name

First Name

Last Name

Phone

(###)

###

####

What are your goals for these sessions? What do you hope to get out of our time together?

Are there any areas in particular you'd like to work on?

Do you have any old injuries or conditions that I need to be aware of? Please describe them all.

Are you experiencing any pain or discomfort? If yes, where and to what degree (1 to 10, 1 being nominal, 10 being unbearable pain)?

Is there anything else I need to know or that you'd like to share?

Liability Waiver

As with any physical activity, I understand that yoga carries a risk of injury. I accept that risk and agree to assume full responsibility for any risks, injuries, or damages, known or unknown, which might incur as a result of my participation. I knowingly, voluntarily, and expressly release, indemnify, and hold harmless Lindsay Majer from any loss, cost, personal injury, or liability claims.

I accept and agree.

I do not accept.