Māyurveda Intake

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Māyurveda

You are here because you are interested in a Māyurveda {preparing, pregnant, postpartum or petites} sacred anatomy + self-care with Kaya. Once we get started, we will delve more specifically into your health and constitution. This form helps me establish what your general needs and current situation is so that I can design an approach that is just right for you! We may also check in on the phone. If the form does not submit, scroll up and find highlighted incomplete fields. Yes, this works from a mobile device.

Your answers go directly to Kaya and remain confidential.

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

I am... *

Planning a pregnancy Struggling to get pregnant 1st Trimester 2nd Trimester 3rd Trimester Postpartum Deep in Mamahood Rejuvenating for the next pregnancy A yoga teacher who wants to support women during pregnancy

Describe your family {adults in the home, how many kids, previous pregnancies etc.} *

Exposure to Ayurveda *

None I have read some books / articles I have done a dosha quiz I have seen a practitioner before I have had ayurvedic bodywork before I already have an Ayurvedic Lifestyle and Diet I have some information but am not using it in my life

Click all that apply

Exposure to Yoga *

I am a yoga teacher! I have a home practice I attend classes I am new to yoga I would like to do yoga I am not interested in yoga Other

Main health and lifestyle hopes & challenges regarding your Mamahood {at whatever stage you are in, or what you forsee} *

Means of support I think I need *

Food + Digestion {aka, what do I eat each trimester or feed my baby / kids?} Botanicals {aka, what herbs, teas and tinctures are safe or beneficial for me, my birth or my baby} Anxious Mama {aka, what are all the things I should be avoiding?} Yoga Mama {aka, what poses can or should I do or avoid each trimester} Lifestyle {aka sleep, exercise, poops} Perspective {aka, I could use some yogic wisdom right about now, cause I am freaking out!} Stuff Stuff {aka, I need a curator for natural birth or baby stuff} Wisdom {aka I need some help with body image, understanding my constitution or my children's constitutions} Birth! {help me prepare for birth with some yogic and ayurvedic tools}

Expand on the above if needed *

Communication style *

I would love articles to read Skype Phone In person {Bay Area, California}

Your Skype ID *

Frequency of support *

I want a sister! I want support and contact every month {eg for each month of pregnancy plus postpartum}! I want a friend! Let's check in every trimester I just want one or two checkins I'm not sure

If possible, please include a photo of you! *

Max file size: 20MB

Birth Date, Time and Location *

If you have this information, please share! We will use it to look at your vedic astrology chart and determine more details about your health and constitution

Anything else to share? *

How did you hear about Kaya? *

I am a client or student of Kaya's already Internet Search Facebook Friend Instagram Practitioner referal Other

If Other please specify: *

Submit

Kaya is the founder of SRY™ which is based in the full spectrum of the Vedic yoga tradition. She has been teaching therapeutic restorative yoga therapy since 2001. Kaya's work is healing, transformative, deeply rejuvenating and empowers her student and clients with wisdom and inner experience. Her trained in the full spectrum of the Vedic Tradition includes Yoga, Yoga Therapy, Prenatal Yoga, Ayurveda, Women's Health, Eastern Anatomy, Sanskrit, Vedic Astrology and Vedanta Philosophy. She collaborates with her husband Michael Manzella, a Vedic Astrologer, to serve yoga students and teachers who are inclined toward depth of inner experience and knowledge. MORE ON KAYA

About
SRY
Ayurveda
Work with Me
Audio
Contact
- Resources