1:1 Private Yoga Instruction Intake Name * First Name Last Name Preferred Pronouns How would you like to be addressed. Select from the drop-down menu. She / Her He / Him They / Them Email * What are your goals for private instruction? What are you hoping to gain from our sessions? * Where are you located? (City + Country) & What time zone are you in? * This supports our scheduling. Preferred Days of Week (Select top 2) * Monday Tuesday Wednesday Thursday Preferred Time of Day * Morning Afternoon Early Evening Desired length of each session * 60 Minutes 75 Minutes 90 Minutes Do you have any current and/or chronic injuries that should be noted? * Please describe your experience with yoga, pranayama, breathwork or meditation. I acknowledge that Gabriela Colletta (Gaby) is not a doctor or physician and is not trained to provide medical diagnosis, medical treatment, or any other type of medical advice. * (Sign below by typing full name). I acknowledge that as the undersigned, I knowingly and voluntarily assume the risk of participating in a yoga class / private lesson / retreat with Gabriela Colletta (Gaby). The undersigned expressly waives, releases, discharges, and agrees not to sue from any liability of personal injury, disability, death, loss of property or action of any kind. * (Sign below by typing full name). Thank you!