please fill out the healthcare form below prior to attending a retreat, class or workshop with me… name * First Name Last Name email * have you practiced yoga before? yes no please answer as appropriate. if there is anything you are unsure about contact your GP. high/low blood pressure [feeling dizzy or faint] do you suffer from asthma or breathing difficulties? suffer from pain or discomfort in certain areas ie back, hips, knee, neck any chest pain / heart problems do you have any old injuries that still trouble you? are you / could you be, pregnant, or have you given birth in the last six weeks? any major surgeries? none of the above if answered yes to anything above or any other medical conditions not covered above that might be adversely affected by yoga practice please give details below do you have any other conditions, which affect your mobility or are likely to cause you concern when doing yoga? I take full responsibility for my health during the yoga classes. I will inform my yoga teacher of any medical changes. do you have any allergies or dietary requirements? if yes, please note below so we can cater for your needs accordingly Thank you! I can’t wait to meet you on the mat xxx back to booking