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Please fill this in if you are planning to come to class or have a private session with me. All details are stored according to Soul Yoga's Privacy Policy.

*Please note this does not automatically assure you place in a class, please use the contact form, text or email to book into a class.

Health Questionnaire

These conditions require specific modifications or affect your practice. If ticked, please give details. Please tick all that apply to you.

abdominal disorder or recent surgery

arthritis

back pain

knee pain

hip problem

shoulder or neck problem

heart disorder

high blood preasure

low blood preasure

asthma

diabetes

auto-immune disorder (e.g. ME, MS, Lupus etc )

epilepsy

anxiety/depression

sensory disorder affecting eyes or ears

balance affecting disorder

other-to be discussed with teacher

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