Health Questionnaire
This questionnaire has been designed to help you to enjoy your class safely. All information given will remain private and confidential.
Email *
Name *
Telephone No : *
Age Group *
Required
Have you practised yoga before? *
Have you any history of heart trouble? *
Have you suffered from any serious illness/or undergone any surgery in the last 6 months? *
Have you suffered from any serious illness/or undergone any surgery in the last 6 months? *
Do you regularly take medication? *
Have you had a baby in the last six months? (It is advisable not to resume any form of exercise for 12 weeks following the birth.) *
Have you had a baby in the last six months? (It is advisable not to resume any form of exercise for 12 weeks following the birth.) *
Do you suffer from any of the following? (if ‘yes’ please give further details on 'any other comments' section)
Clear selection
IF IN ANY DOUBT PLEASE SEE YOUR DOCTOR
If there are any other conditions that may effect your participation please detail those below in the section provided for any other comments.
Please say briefly why you are joining the class: *
Any other comments:
With regards to all forms of exercise if you have any doubt about your level of health and fitness it is advisable to consult your GP prior to the commencement of any new fitness plan. The instructor must be informed of any injuries, handicaps or medical problems prior to joining the classes. Tina Olliver/Yoga-etc cannot accept responsibility for personal injury whilst participating in a class if a) You have been advised against exercise on the basis of a pre-existing health condition by your GP.b) You fail to observe the techniques & instructions given regarding safety. I acknowledge that I exercise at my own risk. *
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