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Develop Your Personal Yoga Practice Program Application

This form helps me decide if you are the right fit for this program. Plus if I am the right fit for you.  I am prioritising due to limited numbers. It's not an assessment.

Please contact me via email if you don't receive a response within 5 business days.

Click the button below to start.

Start

Question 1 of 9

What is your full name, email, location (city and country) and phone number (if in Australia)?

Question 2 of 9

How did you hear about me and this program?

Question 3 of 9

What age bracket do you currently fall in?

A

18-21

B

22-30

C

31-39

D

40-49

E

50-59

F

60+

Question 4 of 9

Have you practiced yoga before? If so, please elaborate...

Question 5 of 9

What is your current biggest frustration with your health? And what are you hoping to achieve with this program?

Question 6 of 9

What do you think is your biggest obstacle to you achieving this goal?

Question 7 of 9

Would you be willing for your sessions to be used as a case study for my yoga therapy studies?
(your first and last name are only required). It will cost you $97 (you will get a discount of $40).

A

Yes

B

No

Question 8 of 9

How committed are you to this program? 1 being not committed at all. 10 being more than 100%

A

1

B

2

C

3

D

4

E

5

F

6

G

7

H

8

I

9

J

10

Question 9 of 9

Would you like to subscribe to my email list (if you haven't already)?

A

Yes

B

No

Confirm and Submit