Shambhavi Yoga Studio - Yoga Health Questionnaire & Consent Form For New Students
The purpose of this questionnaire is to help your yoga teacher better understand about your fitness and health level in order to address your general expectations from our yoga classes. This information will be used for the evaluation of your health and readiness to begin our exercise program. The form is extensive, but please tries to make it as accurate and complete as possible.
Email address *
Which type of yoga you want to learn?
Family Medical History (If any):
Your answer
Are you currently under a doctor's care, if yes explain:
Your answer
How physically active is your lifestyle currently (Scale of 1-10, 10 being the most active)? :
Have you done yoga before? Y / N
Height / Weight / Age
Your answer
How stressful is your job (Scale of 1–10)
Phone number *
Your answer
Do you suffer from any of the following health issues? Check where applicable
Email Id *
Your answer
Date of Birth *
Your answer
If Yes Specify No. of Years:
Your answer
Marital Status
What are your expectations and/or goals from your yoga class?
Your answer
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