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Prayog Intake Form
Thank you for choosing Prayog🙏🏼 
We are committed to helping you find relief from your health concerns with ease and comfort. Our holistic approach identifies and addresses root causes, supporting your physical and mental well-being in a way that suits your schedule and budget, ensuring lasting and meaningful results.

This form is used to collect information about your medical & health history and is for internal purposes only. The information you provide is confidential and will be treated accordingly.


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Full Name
Gender
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Date of birth
MM
/
DD
/
YYYY
City/Province & Country
Nationality
Mobile Number (For daily updates), with country code.
Email ID 
Occupation
Current Weight (in kg)
Height (in cm)
Body Fat % or share your Body Composition Analysis to us on whatsapp (If Diet Included)
Measurements in cm in the sequence of Arms, Chest, Waist, Buttocks, Thighs. Refer the link below.Measurement reference (If Diet Included)
How did you hear about Prayog?
 *
Required
If it's WA group/Friend/Networking group, please mention the name.
Do you Exercise? If yes, what type?
What are your goals/expectations from Prayog? What benefits do you seek? (check all that apply) 
Check the conditions that have affected your health either recently or in the past.
Are you currently taking any medications? If yes, please list down the names.
Do you have any physical limitations or injuries that affect your movement? (If Yoga included) If Yes, please explain. 
Is there any other information you would like to share?
I am comfortable providing my before- after pictures (only if it about weight management), and can be used on social media.
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I am comfortable getting my pictures clicked during the session for tracking my postures/alignment progress.
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Which Prayog's Program have you chosen based on your goals? *
Required
 *Prayog Fusion Flow:-
It includes Stretching, Cardio, Asanas/strength training/ Vinyasa, Relaxation techniques, Pranayam, Meditation

Individuals who have physiological limitations/ certain injuries/ elderly/ beginners/ pregnant/ with specific goals are advised to take 1:1 session over group classes. 

Also this program is time bound so try to attend as many sessions as possible.

In-person charges may vary based on the health conditions and the location. Currently, available in Dubai.

If it’s Fusion Flow(Group Class), which time slot would you choose?
Prayog Guidelines Consider only ones which are applicable to your chosen program.

âś… At least 2 hrs of fasting is required before the session as well as for BCA & Measurements.

âś… Please be present at least 5 min earlier for adjustment of the device, Internet, etc (for online).

âś… Adjust your camera so that you are fully visible from head to toe, in standing or lying position.

âś… Yoga mat or an anti-slippery carpet is must.

✅ Yoga accessories like bolster, bricks, strap, dumbbells, etc. may facilitate certain movements.   

âś… Avoid sessions on periods or illness and inform prior on WhatsApp.

✅Inform prior ( at least 1 hr in advance) if you’re not able to attend the session

âś… In the group session, listen to your body and avoid overexertion. Also, respect each other's time and try to

catch up together, while being mindful of your own capacity.

âś…The Diet Plan (if included) will be provided once you successfully finish Week 1 Habit stacks.

✅ Follow Prayog’s Social Media handles for regular health updates- Click Instagram, Facebook, LinkedIn

✅ Your 1-month program’s validity, for 1:1 = 35 days; for group = 28 days, from the 1st session.

✅You’ll receive gentle reminders on whatsapp prior to your sessions, response with 👍🏻to confirm.

âś…Payment has to be made before your program starts.


Payment details
Once form is submitted. The payment link will sent to you.
By joining, I affirm that I am solely responsible for my health and well-being, as well as my decision to practice yoga, a program of physical exercise. I agree to inform my instructor of any activities or movements which I feel could cause injury to myself. I understand that yoga/meditation/breathing techniques are not recommended and are not safe under certain medical conditions. In case of Nutrition, I will not follow crash dieting or get carried away with online informations. I'll consult my Nutritionist before making any changes in my Diet. Prayog shall not be held liable for any injury, loss, or damage to property and/or persons sustained during or because of participation in these programs. I agree to listen to my body and monitor myself during every session.
If I see a positive change in my health, I would be willing to provide a short testimonial video to Prayog.
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