Health Questionnaire
Thank you for taking the time to complete this form.  Whilst I offer variations to poses where possible, it is helpful for me to know of any specific issues that might impact on your yoga practice.  This is also required for insurance purposes.  All information is treated in the strictest confidence and stored in accordance with General Data Protection Regulations (GDPR).
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Name (first name and surname) *
Mobile phone number
A text will be sent in the event of any unforeseen cancellation of class
 *
Emergency name
Person(s) to be contacted in the event of an emergency
 *
Emergency contact number
Phone number of emergency contact(s)
Medical conditions 
Please list anything that could affect your yoga practice for example high/low blood pressure, diabetes, asthma, hearing loss, heart conditions, dizziness, back pain, neck, knee or shoulder problems, recent surgery or pregnancy. If none please put that.
 *
Why are you interested in practicing yoga?
Choose any which are appropriate
How did you hear about Calm - Yoga with Nicole?
Choose any which are appropriate
All classes follow the British Wheel of Yoga guidelines for safe practice
I agree that I will be engaged in physical activity and assume any responsibility for my actions. 
 *
I agree to Calm - Yoga with Nicole contacting me further by the details provided above. *
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