Student QuestionnaireAdaptive Yoga - One-on-One Sessions Student's Name * First Name Last Name Date of Birth * Current Age * Your Name (if different than student) First Name Last Name Relationship to student Email * Phone (###) ### #### Are there physical symptoms of your current diagnosis that may effect the yoga practice? * Do you have seizures? Triggers? * Do you have any goals for your yoga practice? Do you currently use any adaptive equipment or assistive technology? Do you have a preference of practicing on a mat or in a chair? Or are you not sure at this moment? Anything else you would like us to know? Session Policies * Private yoga sessions for individuals with diverse abilities are $70/session and sessions range from 30-45 minutes. We offer a first time trial session for $35 that. is 60-minutes in length. All sessions must be paid for at the time of booking. We ask for 24 hours notice to cancel or reschedule your appointment. There is a $35 cancellation fee for any appointments rescheduled or cancelled within 24 hours. Some students will acclimate to yoga classes quickly and others may need more time. When a session is scheduled, we are committed to working with students for the entire time; however, if continuing with class seems potentially harmful to the student, space, or instructor, a session may be ended early. In this case, the full session investment will still be required. I Agree I Disagree Thank you! We will be in touch should we have any further questions. Please feel free to contact suzanne@humblehavenyoga.com should you have any additional questions or comments!
