YogaAppointments available NOW! Please fill out yoga intake form below if you are booking a class or a consult.Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Date of Birth (mm/dd/yy) *GenderFemaleMaleTransgender Female / Transgender WomanTransgender Male Transgender ManTwo-spirit O Genderqueer / Gender FluidIntersexNon-binary/Gender Non-ConformingOtherDecline to answerWhat pronoun(s) do you prefer?How did you hear about us?InstagramFacebookYouTubeWord of MouthPlease tell me more about your previous yoga experience: *First TimeBeginnerIntermediateAdvancedWhat is your reason for wanting to practice yoga? *What is your ultimate goal here at Eclectic Energies? *Please list any medical conditions (including pregnancy) or injuries that you may have: *Emergency Contact (Name & Phone #) *Is there anything else you'd like to share? Submit