Welcome to your one-on-one wellness journey

Please complete this short intake form before your first session so your coaching can feel personal, grounded, and supportive from the start.

Welcome to Nomadic Goddess Yoga

This intake form helps your coach understand your goals, current habits, wellness history, and what kind of support feels best for you.

There are no perfect answers. Share what feels true and comfortable.

Please complete the form before your first session.

Your responses will help shape a thoughtful coaching experience that meets you where you are.

Set aside a few quiet minutes, answer honestly, and skip anything that does not apply.

Your information will be used to prepare for your one-on-one wellness coaching sessions with care.

Name

Shift pattern/typical work week

Average hours of sleep, and how sleep feels lately

Best days/times for our weekly sessions

Any injuries, pain, or areas of tightness right now

Movement you already do (if any)

Equipment/space available at home (mat, bands, weights, floor space)

Anything a doctor has told you to avoid or modify

Stress level lately, 0-10

What's driving that stress (shift load, home life, etc.)

How your mind feels after a shift (wired, foggy, flat, other)

Any breathing or relaxation practice you already use

What would "consistent" look like for you in 4 weeks?

Main goal

Yoga experience

Breathwork experience

Strength training experience

Anything you want more of, or want to avoid, in our sessions

Pregnant, recent surgery, cardiac or seizure history? (details if yes)

Emergency contact name

Emergency contact number