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Health Questionnaire

If I have not taught you yoga before, prior to taking either live or pre-recorded classes, please fill out the following form to help me understand a little more about you.

First Name

Email Address

Last Name

Date of Birth

Have you done yoga before?

No

Yes

If yes, do you know what type, how long for and how frequently?

Are you currently suffering from (or have recently suffered from) a medical condition, illness, or injury?

No

Yes

If yes, please can you provide a little more information so that I can understand whether you might need any modifications in class?

I declare that the info I’ve provided is accurate & complete

I want to subscribe to That Yoga Woman's newsletter to keep up to date on what's happening

Thank you for completing the health questionnaire.

Join my mailing list to receive yoga updates

Thanks for submitting - you'll be added to my mailing list!

Newbiggin-by-the-Sea, Northumberland.

Tel: +44 7584034708

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