Mobility Goals

Name *

First Name

Last Name

Positions for Postures & Practices *

My goal as a teacher is that you will be able to fully participate in all elements of each class. Please confirm with a check mark that you are comfortable participating in postures and practices in the following positions:

Supine (on your back)

Prone (on your belly)

Side Lying (on your side body)

Seated (on a chair)

Seated (on the floor)

Kneeling (on your hands and knees)

Kneeling (upright, hands not on the floor)

Standing (with support of a chair)

Standing (with no support)

Standing Forward Fold (head below heart)

What do you plan to focus on over the next four weeks of this program? *

(Check all that apply)

joint mobility

spine mobility

strength

balance

establishing a regular routine around physical activity

Which of the following would you prefer for the next four weeks? *

4 mini practices, each 15 minutes long, with NO savasana

3 mini practices, each 20 minutes long, with savasana

Would you prefer to replace one of the current segments with a Yin practice? *

Yes

No