YiA YOGA works with various massage therapists & body workers to ensure we have the perfect fit just for you. Please fill out the following form so we can best place you with the optimal treatment for your body & your current needs & desires. 

Name *
Name
Phone
Phone
Date of Birth
Date of Birth
Please check the areas of the body you would like worked on during the massage?
On a scale of 1 to 10 how much pressure would you like during the massage?
Do you have or have you had any of the following conditions? Check appropriate boxes.
Would you prefer a male or female masseues?