Questionnaire

Health Form

HEALTH QUESTIONNAIRE & CONSENT FORM FOR NEW STUDENTS

The purpose of this questionnaire is to help your yoga teacher get to know you and your health better. This way the teacher can safely guide you through your practice and meet your needs.
Name
MM slash DD slash YYYY
Address
Which aspects of Yoga most interest you? (Please click as many as you wish)
Are you affected by any of the following?
Yoga can be practiced safely by most people. However, there are certain conditions which require special consideration in class.
Are you affected by any of the following?
Have you recently...?
Are you ...?
I take responsibility for my health during the yoga classes, including my injuries. I will inform my yoga teacher of any medical changes. Ashtanga Yoga Vevey does not take any responsibility for injuries from, or as a consequences of your participation in classes.
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