Health questionnaire

If this is the first time you book a yoga session with Great Dane Yoga, or if there are any changes to your condition since last time you booked, You must complete this form.

Full Name

Address

Phone

previous yoga experience *

Complete beginner

Done one or two classes

Been practicing less than a year

Been practicing over one year

Been practicing 5 years or more

Returning to yoga after a break

Which class/classes are you interested in signing up for?

Grounding Vinyasa (Online)

Energising Vinyasa (Online)

Yin Yoga (Online)

Full Service (Online)

Beginners Yoga (Online)

Pre Recorded classes

Garden Yoga (In person)

1 to 1 Yoga (Online)

1 to 1 Yoga (In person)

Have you taken a class with me, either in person (studio,gym, event) or online, before? *

Yes

Please tell me about any injuries or conditions that may affect your practice. Including: Back or joint issues, high or low blow pressure, heart conditions or any other medical conditions.

Are you hoping to achieve anything specific from doing yoga?

Are you pregnant? *

Yes

Not aplicable

I understand that it is my responsibility to listen to my body and stay safe during any yoga or exercise. I take full responsibility for my own participation, and any injuries that may occur.

I give permission for Great Dane Yoga to store my information. Information will be treated with strict confidentiality and will not be shared with any third party.

Thanks for submitting!

Great Dane Yoga

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