Join Free Class
New Yoga Client Intake and Health History Form
Please fill out the following health declaration form in order to participate in our activity.
Have you practiced yoga before?
On a scale 1-10 (10 being highest), how would you rate your level of daily activity?
What styles of yoga have your pacticed before?
How often do you practice yoga?
Choose an option
On a scale 1-10 (10 being highest), how would you rate your level of daily stress?
What are your health goals for your yoga practice?
Improve overall health
Alternative therapy (explain below)
Address specific health concern (explain below)