Yoga Therapy Intake Form

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Yoga Therapy Intake Form

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First Name
Last Name
Acme LLC.
First Name
Last Name
Corporation Corp.
First Name
Last Name
Acme LLC.
First Name
Last Name
Corporation Corp.

Yoga Therapy Intake Form

Fully editable with custom branding. Send, print or embed online.

Yoga Therapy Intake Form

Fully editable with custom branding. Send, print or embed online.

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Date: March 8th 2023



Acme LLC.

Corporation Corp.

This Contract is between Client (the "Client") and Acme LLC, a California limited liability company (the "Coach").

The Contract is dated January 23, 2023.


1.1 Project. The Client is hiring the Coach to develop a coaching relationship between the Client and Coach in order to cultivate the Client's personal, professional, or business goals and create a plan to achieve those goals through stimulating and creative interactions with the ultimate result of maximizing the Client's personal or professional potential.

1.2 Schedule. The Coach will begin work on February 1, 2023 and will continue until the work is completed. This Contract can be ended by either Client or Coach at any time, pursuant to the terms of Section 4, Term and Termination.

The Coach and Client will meet by video conference, 4 days per month for 2 hours.

1.3 Payment. The Client will pay the Coach an hourly rate of $150. Of this, the Client will pay the Coach $500.00 (USD) before work begins.

1.4 Expenses. The Client will reimburse the Coach's expenses. Expenses do not need to be pre-approved by the Client.

1.5 Invoices. The Coach will invoice the Client in accordance with the milestones in Section 1.3. The Client agrees to pay the amount owed within 15 days of receiving the invoice. Payment after that date will incur a late fee of 1.0% per month on the outstanding amount.

1.6 Support. The Coach will not be available by telephone, or email in between scheduled sessions.


- A coaching relationship is a partnership between two or more individuals or entities, like a teacher-student or coach-athlete relationship. Both the Client and Coach must uphold their obligations for the relationship to be successful.

- The Coach agrees to maintain the ethics and standards of behavior established by the International Coaching Federation (ICF).

- The Client acknowledges and agrees that coaching is a comprehensive process that may explore different areas of the Client's life, including work, finances, health, and relationships.

- The Client is responsible for implementing the insights and techniques learned from the Coach.


3.1 Overview. This section contains important promises between the parties.

3.2 Authority To Sign. Each party promises to the other party that it has the authority to enter into this Contract and to perform all of its obligations under this Contract.

3.3 Coach Has Right To Give Client Work Product. The Coach promises that it owns the work product, that the Coach is able to give the work product to the Client, and that no other party will claim that it owns the work product. If the Coach uses employees or subcontractors, the Coach also promises that these employees and subcontractors have signed contracts with the Coach giving the Coach any rights that the employees or subcontractors have related to the Coach's background IP and work product.

3.4 Coach Will Comply With Laws. The Coach promises that the manner it does this job, its work product, and any background IP it uses comply with applicable U.S. and foreign laws and regulations.

3.5 Work Product Does Not Infringe. The Coach promises that its work product does not and will not infringe on someone else's intellectual property rights, that the Coach has the right to let the Client use the background IP, and that this Contract does not and will not violate any contract that the Coach has entered into or will enter into with someone else.

3.7 Client-Supplied Material Does Not Infringe. If the Client provides the Coach with material to incorporate into the work product, the Client promises that this material does not infringe on someone else's intellectual property rights.


This Contract is ongoing until it expires or the work is completed. Either party may end this Contract for any reason by sending an email or letter to the other party, informing the recipient that the sender is ending the Contract and that the Contract will end in 7 days. The Contract officially ends once that time has passed. The party that is ending the Contract must provide notice by taking the steps explained in Section 9.4. The Coach must immediately stop working as soon as it receives this notice unless the notice says otherwise.

If either party ends this Contract before the Contract automatically ends, the Client will pay the Contractor for the work done up until when the Contract ends. The following sections don't end even after the Contract ends: 3 (Representations); 6 (Confidential Information); 7 (Limitation of Liability); 8 (Indemnity); and 9 (General).


The Client is hiring the Coach as an independent contractor. The following statements accurately reflect their relationship:

- The Coach will use its own equipment, tools, and material to do the work.

- The Client will not control how the job is performed on a day-to-day basis. Rather, the Coach is responsible for determining when, where, and how it will carry out the work.

- The Client will not provide the Coach with any training.

- The Client and the Coach do not have a partnership or employer-employee relationship.

- The Coach cannot enter into contracts, make promises, or act on behalf of the Client.

- The Coach is not entitled to the Client's benefits (e.g., group insurance, retirement benefits, retirement plans, vacation days).

- The Coach is responsible for its own taxes.

- The Client will not withhold social security and Medicare taxes or make payments for disability insurance, unemployment insurance, or workers compensation for the Coach or any of the Coach's employees or subcontractors.


6.1 Overview. This Contract imposes special restrictions on how the Client and the Coach must handle confidential information. These obligations are explained in this section.

6.2 The Client's Confidential Information. While working for the Client, the Coach may come across, or be given, Client information that is confidential. This is information like customer lists, business strategies, research & development notes, statistics about a website, and other information that is private. The Coach promises to treat this information as if it is the Coach's own confidential information. The Coach may use this information to do its job under this Contract, but not for anything else. For example, if the Client lets the Coach use a customer list to send out a newsletter, the Coach cannot use those email addresses for any other purpose. The one exception to this is if the Client gives the Coach written permission to use the information for another purpose, the Coach may use the information for that purpose, as well. When this Contract ends, the Coach must give back or destroy all confidential information, and confirm that it has done so. The Coach promises that it will not share confidential information with a third party, unless the Client gives the Coach written permission first. The Coach must continue to follow these obligations, even after the Contract ends. The Coach's responsibilities only stop if the Coach can show any of the following: (i) that the information was already public when the Coach came across it; (ii) the information became public after the Coach came across it, but not because of anything the Coach did or didn't do; (iii) the Coach already knew the information when the Coach came across it and the Coach didn't have any obligation to keep it secret; (iv) a third party provided the Coach with the information without requiring that the Coach keep it a secret; or (v) the Coach created the information on its own, without using anything belonging to the Client.

6.3 Third-Party Confidential Information. It's possible the Client and the Coach each have access to confidential information that belongs to third parties. The Client and the Coach each promise that it will not share with the other party confidential information that belongs to third parties, unless it is allowed to do so. If the Client or the Coach is allowed to share confidential information with the other party and does so, the sharing party promises to tell the other party in writing of any special restrictions regarding that information.


Neither party is liable for breach-of-contract damages that the breaching party could not reasonably have foreseen when it entered this Contract.


8.1 Overview. This section transfers certain risks between the parties if a third party sues or goes after the Client or the Coach or both. For example, if the Client gets sued for something that the Coach did, then the Coach may promise to come to the Client's defense or to reimburse the Client for any losses.

8.2 Client Indemnity. In this Contract, the Coach agrees to indemnify the Client (and its affiliates and their directors, officers, employees, and agents) from and against all liabilities, losses, damages, and expenses (including reasonable attorneys' fees) related to a third-party claim or proceeding arising out of: (i) the work the Coach has done under this Contract; (ii) a breach by the Coach of its obligations under this Contract; or (iii) a breach by the Coach of the promises it is making in Section 3 (Representations).

8.3 Coach Indemnity. In this Contract, the Client agrees to indemnify the Coach (and its affiliates and their directors, officers, employees, and agents) from and against liabilities, losses, damages, and expenses (including reasonable attorneys' fees) related to a third-party claim or proceeding arising out of a breach by the Client of its obligations under this Contract.


9.1 Assignment​. This Contract applies only to the Client and the Coach. Neither the Client nor the Coach can assign its rights or delegate its obligations under this Contract to a third-party (other than by will or intestate), without first receiving the other's written permission.

9.2 Arbitration. As the exclusive means of initiating adversarial proceedings to resolve any dispute arising under this Contract, a party may demand that the dispute be resolved by arbitration administered by the American Arbitration Association in accordance with its commercial arbitration rules.

9.3 Modification; Waiver. To change anything in this Contract, the Client and the Coach must agree to that change in writing and sign a document showing their contract. Neither party can waive its rights under this Contract or release the other party from its obligations under this Contract, unless the waiving party acknowledges it is doing so in writing and signs a document that says so.

9.4. Noticies.

(a) Over the course of this Contract, one party may need to send a notice to the other party. For the notice to be valid, it must be in writing and delivered in one of the following ways: personal delivery, email, or certified or registered mail (postage prepaid, return receipt requested). The notice must be delivered to the party's address listed at the end of this Contract or to another address that the party has provided in writing as an appropriate address to receive notice.

(b) The timing of when a notice is received can be very important. To avoid confusion, a valid notice is considered received as follows: (i) if delivered personally, it is considered received immediately; (ii) if delivered by email, it is considered received upon acknowledgement of receipt; (iii) if delivered by registered or certified mail (postage prepaid, return receipt requested), it is considered received upon receipt as indicated by the date on the signed receipt. If a party refuses to accept notice or if notice cannot be delivered because of a change in address for which no notice was given, then it is considered received when the notice is rejected or unable to be delivered. If the notice is received after 5:00pm on a business day at the location specified in the address for that party, or on a day that is not a business day, then the notice is considered received at 9:00am on the next business day.

9.5 Severability. This section deals with what happens if a portion of the Contract is found to be unenforceable. If that's the case, the unenforceable portion will be changed to the minimum extent necessary to make it enforceable, unless that change is not permitted by law, in which case the portion will be disregarded. If any portion of the Contract is changed or disregarded because it is unenforceable, the rest of the Contract is still enforceable.

9.6 Signatures. The Client and the Coach must sign this document using Bonsai's e-signing system. These electronic signatures count as originals for all purposes.

9.7 Governing Law. The validity, interpretation, construction and performance of this document shall be governed by the laws of the United States of America.

9.8 Entire Contract. This Contract represents the parties' final and complete understanding of this job and the subject matter discussed in this Contract. This Contract supersedes all other contracts (both written and oral) between the parties.



Acme LLC.

Corporation Corp.
Table of contents

Most yoga therapists require their students to fill out a client intake form before beginning a yoga therapy session. The main goal is to get to know your clients by learning some critical facts about them and giving them a chance to provide crucial information that they might not otherwise be able to (i.e. health conditions, long term goals, etc...).

Although it might seem a little "extra," this is a great chance to find out about any medical issues or personal situations that your students feel might affect their yoga practice. It's also a terrific first step in building trust between you and your clients. So what are the specific questions you should ask on your yoga therapy intake form? Read on to find out.

Note: Take your business to the next level with Bonsai's all-in-one product suite. We help streamline your processes from client onboarding to invoicing, payments, accounting and much more. Come on board, we've got you covered! Try a 7-day free trial here.

What Questions Should You Ask Your New Yoga Therapy Clients?

The specific questions you ask may vary depending on your business requirements but try to keep this form straightforward and focus on establishing a welcome environment for your yoga students making them feel valued from the time they contact you.

Here are some of the vital elements you must make sure to address on your intake form before you start the yoga therapy sessions.

Contact Information

Begin your intake form with the client's basic contact information. Here's what they should provide.

- Full name

- Date of birth

- Phone number (cellphone, work, home phone)

- Emergency contact name and further details (relationship, phone number, address, etc...)

- Billing/physical address

- Insurance information

Practice Experience

It's a great idea to include a set of questions to evaluate your client's previous experience with any other yoga therapist or similar activities. Here are some questions you can include in this section.

- Have you ever done yoga before? If so, when was the last time you practiced?

- How frequently do you practice yoga?

- What yoga styles have you practiced?

- Have you tried any other holistic alternative therapies?

- What do you find is the most challenging about your current practice? (yoga postures, time invested, lack of space, etc...)


Next, try to get some useful insights on the client's lifestyle and habits. Asking your patient about their routine will help you make simple lifestyle recommendations that might help them live healthier lives. You can include the following inquiries.

- What are your favorite physical activities? What's your least favorite?

- Do you workout on a regular basis? Please explain:

- Describe your sleeping and resting habits. (For example, hours, naps, difficulties getting or keeping asleep)

- What do you eat on a daily basis?

- Do you smoke, drink, or use other recreational drugs?

- Please explain your spiritual beliefs and practices.

- Does your energy change or stay the same throughout the day?

- How much caffeine do you take in each day?

Physical Health History

Some yoga postures might be contraindicated under certain medical conditions, so it's important that your client is open and honest about their health history including surgeries, treatments, diagnosis etc. Remind your client that the yoga therapy does not substitute medical examination and they should always seek their primary physician for such service.

Try including some of the following questions to gather more vital information.

- Describe the places of your body that are uncomfortable or painful. Try to describe their location as well as the type/degree of discomfort.

- What functional movements or tasks are you finding difficult? (standing, bending, sitting for long periods, etc...)

- What other healthcare professionals are you seeing for your health concerns or overall well-being? How frequently do you see them?

- Make a list of your current and former medical issues. Include medical diagnoses, operations, accidents, injuries, and so on, as well as approximate dates.

- Do you take pain relievers?

- Are there any serious injuries or hospitalizations that you have had in the past, even if you are not now experiencing symptoms?

- Do you have any other conditions or injuries that you have not yet discussed? (depression, cancer,

Goals and Expectations

Last but not least, include a set of questions to help you ensure the services you provide are appropriate for the client and that you fully understand what outcomes they are expecting to get out of the treatment.

- Why are you seeking yoga therapy?

- Considering your time limitations, what amount of time (daily, weekly or monthly) can you reasonably invest in this yoga therapy?

- What objectives do you hope to achieve through yoga therapy? (flexibility, balance, stress/anxiety reduction, muscular tension relief, etc...)

- What are your current life challenges?

- What areas of your life bring you the most happiness and pleasure?

- What would you change now, if you had the power to?

Create the Perfect Intake Forms With Bonsai

If you are ready to draft the perfect client intake form for your yoga therapy practice? Use Bonsai's custom form builder to easily create a professional branded document that you can quickly share with your new clients via email or URL link. You can also have the document embedded to your business website which is incredibly helpful to increase leads and streamline the overall onboarding process.

Our forms are fully customizable, allowing you to add as many questions as you need with your preferred answer format, rearrange fields and add your own branding elements to make the intake form unique. Sign up for a 14-day free trial and get your new intake form today!

Frequently Asked Questions
Questions about this template.

What are some examples of yoga therapy?

There are many different types of yoga therapy: breathing exercises, meditation, yoga postures, guided imagery, relaxation exercises.

Is yoga a form of psychotherapy?

Yoga is more of a form of supplemental therapy. The movement and breathing exercises are a great addition to traditional therapy methods.

What is the goal of yoga therapy?

Eliminating, minimizing, or managing symptoms that cause suffering is one of yoga therapy's goals or objectives.