I’m looking forward to meeting you soon. Please take a moment to fill out the form below so I can get to know you better before our meeting.

Name

First Name

Last Name

Phone

Emergency Contact Name & Phone

What is your loved one's name and relationship to you?

Date of your loved ones' death:

What other losses/transitions have been significant for you?

Who has been supportive to you and what is their relationship to you?

Besides people, have certain activities been helpful to you? Please list:

What has been most difficult since the death of your loved one?

What are your hopes and expectations for our time together?

How did you find Yoga for your Grieving Heart?

Is there anything else you'd like Susannah to know?

To streamline the process, we prefer receiving payment in advance. The fee is $75.00

Please provide at least 24 hours' notice if you need to cancel.

PayPal, Venmo, or credit card accepted.

or credit card below:

$75.00