Registration form for postnatal yoga - strictly confidential
Date of baby's birth:
Type of birth (vaginal, forceps, ventouse, c-birth):
Age of any other children
Have you had your 6/8 week check?
Have you seen or are you planning to see a Women's Health Physio (recommended)?
tick any of the following
Any pelvic floor problems
Any urinary problems
Any bowel problems
High blood pressure
Low blood pressure
Upper/lower back, neck or shoulder
Pelvic girdle pain
Pelvic organ prolapse
Please give further details of any health issue, previous surgery or injuries:
Have you practised yoga before?
Can I hold your personal details / contact information on computer / hard copy to comply with GDPR?
Can I contact you with information about other yoga and hypnobirthing courses?
How did you hear about this class/course?
Thank you for filling out this form
As far as I'm aware, I have disclosed to my yoga teacher all information regarding my health relevant to the practice of yoga. I take full responsibility for all applications of yoga I may practise during my yoga class, outside of the yoga classes. I full understand that the recommendations, ideas or techniques expressed and described in yoga classes as well as in books and videos cannot be regarded as substitutes for the advice of qualified medical practitioners. Any uses to which the recommendations, ideas and techniques are put are at my sole discretion and risk.
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