Yoga Intake Form
Thank you for choosing AHH yoga! We are committed to creating a safe and relaxing space that supports growth, creativity, and authenticity! We look forward to working with you!
Please enter your full name *
Please enter your date of birth *
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Please enter your phone number *
Please enter your home address *
Please enter an EMERGENCY CONTACT *
Please list if you were referred by anybody
How did you hear about us?
What do you hope to gain from yoga therapy?
Have you practiced yoga before? *
How often do you practice yoga? (If applicable) *
Are you currently taking any medication? *
We are delighted to have you as a yoga student at Advanced Holistic Health. We believe that Yoga is more than physical exercise. It is a transformative process that integrates body, mind, and emotional tensions to arrive at deeper levels of relaxation and awareness. All exercise programs involve a risk of injury. By choosing to participate in yoga classes, you voluntarily assume a certain risk of injury. By attending class, 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 yoga instructor of any activities or movements, which I feel could cause injury to myself. I agree to listen to my body and monitor myself during every class session. *
Here at Advanced Holistic Health, we have a 3 HOUR CANCELLATION POLICY for Yoga classes. This means that if a client cancels within 3 hours of their class window, they will be charged the full price of service. If you must cancel, we do ask that it is done at least 3 hours prior to your scheduled class. *
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