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Consultation
Form

Please provide the following details so we can contact you and determine the best way to assist you.

Jodie & Alicia

hello@abhyasayoga.com.au
+61 419 269 993

Name *

First Name

Last Name

Email *

Phone

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What service are you enquiring about *

Yoga Therapy

Personalised Practice (Mentoring)

Private Yoga

Yoga Therapy (complete if relevant)

Do have a condition/injury which you are seeking to manage? If so, please give details:

Personalised Practice (complete if relevant)

Are you considering aligning with a mentor to provide you with guidance in developing a personal practice or deepening your existing practice? Please provide some background on how you would like us to work with you:

Private Yoga Session (complete if relevant)

How many people will be part of the session:

Individual Private Session

2x People Private Session

Small Group

What areas of Yoga interest you?

Tick as many as appropriate

Yoga Philosophy

Asana (physical/movement)

Chanting (mantra)

Mudra (body and hand gestures) Pranayama (breathing techniques)

Meditation

Face to Face consultation or online through Zoom?

Zoom

In Person

How did you hear about us?

Thank you!

abhyasayoga_livingyogahealingyoga

abhyasayoga

by appointment—northern rivers nsw
+61 419 269 993 hello@abhyasayoga.com.au
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