Lifestyle Health and Fitness

Yoga Questionnaire

Yoga questionnaire

The questionnaire allows us to gather more information about you, any illnesses or injuries you may have or have had in the past. It enables us to make your Yoga experience enjoyable and as effective for you as possible. Please be as honest and as in depth as possible.

Please complete and submit this form.

 
Name *
Name
Have you or your family had any of the following? *
if yes please list
Do you smoke? *
Have you ever smoked? *
Have you ever injured any of the following areas of your body? *
What are your goals and expectations for this Yoga course? *
Please indicate your Yoga knowlege and experience *
Please indicate your personal interest in Yoga *
PLEASE READ THE FOLLOWING AND ACKNOWLEDGE *
The following information will help you to get the most out of your Yoga sessions. Yoga is more than just physical exercise, it is a transformative practice that integrates your body, mind and emotions to enable you to release tension and allow you to experience deeper levels of relaxtion and awareness. All programmes that include forms of exercise can involve the risk of injury. By choosing to participate in this course you must be aware of your own health issues and risks, so please respect those knowing that you are responsible for keeping your own body safe. I affirm that I am solely responsible for my health and well-being, while I practice Yoga in the Lifestyle Health and Fitness studio. I agree to inform my Yoga instructor of any movements that I feel could cause injury to myself. I do not have any physical conditions or disabilities that would limit or stop my participation in an exercise programme. The instructor (Victoria Fraser) and Lifestyle Health and Fitness shall not be held liable for any injury, loss or damage to property and/or persons sustained during or as a result of participation in these sessions. Agreement with the below statement, acts as an electronic signiture.