Coaching Intake Form

Full Name*

Nickname

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email*

Birthdate*

(if you don’t want to provide your birthdate, please provide your age)

Occupation

Equine Coaching Session Date

Emergency Contact Info

Name

Relationship

Phone

Equine Coaching Questionnaire

How did you find out about Big Sky Yoga Retreats/Cowgirl Yoga?

What experience do you have with horses (describe non-riding experiences, if possible)?

What interests you most about learning from horses?

What do you hope to gain from your experience with the horses?

What life transitions or challenges are you experiencing at this time in your life?

What emotional or physical trauma have you experienced in your life (if you feel comfortable sharing)?

What type of support system (professional and personal) do you have in your life?

Medical & Dietary Info

Do you have any health issues/medical conditions that we need to know about?

If yes, please explain

Do you have any specific injuries that we need to know about?

If yes, please explain

Are you taking any medications?

If yes, please explain

Are you a vegetarian?

Are you a vegan?

Do you have any food allergies or restrictions?

If yes, please explain

Tell us about your food preferences too (i.e. can’t stand chicken, love any kind of beans, etc.) the more specific you are, the better! Please note: we will accommodate all dietary restrictions. Every effort will be made to accommodate dietary preferences, but sorry, we cannot guarantee it, especially if your list is long or complicated.

Fitness Info

Please contact us if you have any questions about your ability to participate in activities. We suggest that you consult your physician about participating following any serious illness or injury.

Describe your current fitness routine

Include the activities you participate in (running, weights, swimming, cycling, pilates, etc.), the frequency with which you participate in each activity (how often, how far, how long), how long you have been doing each activity, and any other relevant info.

What is the main goal of your current fitness routine?

(weight loss, stress reduction, feeling good, etc.)

Please give us more detailed info on your yoga experience

Which styles do you enjoy most, have you attended other yoga retreats, are you a yoga teacher, etc. Otherwise please indicate that you are a beginner.

Do you have any specific health and fitness goals you’d like to share with us?

Do you have previous riding experience?

If yes, please describe for how long, what style, etc.

Please check box:

I understand that there are weight restrictions for horseback riding, for safety reasons. In general, 175-195 lbs. is our max (also depending on your height).

Have you ever experienced altitude sickness before?

Your Intention

What do you hope to get out of this experience with yoga and horses?

Please share your intentions, goals, hopes and dreams, etc.!

Do you have any questions or concerns?

(please call if you would like to discuss.)

Is there anything else that you would like us to know about you?

Soul Shift Equine Coaching Intake Form

Participant Form

Emergency Contact Info

Equine Coaching Questionnaire

Medical & Dietary Info

Fitness Info

Your Intention

@cowgirlyoga