Your Info Needed

Planning to come to one of our classes for the first time? We are delighted and look forward to meeting you!! Please complete this confidential information/waiver form before your first class. If your first class is on-site, I will also have the forms in hardcopy there, but please come 10-15 minutes early to fill it out.

Just need a Zoom link for a class? If you have completed the Confidential Yoga Information Form, and just need the Zoom link for an online class please contact me by email or text (see bottom of page). Please note, I don't do a lot of communications just before class and usually have my phone on focus at least 10 minutes before class starts. Still, if you need the link right away, your best chance to reach me is by text. Thank you!

Confidential Yoga Information Form

Please fill out the following form.

First name

Last name

Phone

Date of birth

Month

Day

Year

Have you been hospitalized in the last 12 months?

Yes

Are you suffering from a medical condition, illness or injury? Don't forget things like osteoporosis, nerve pain, insomnia, depression, anxiety, etc.

Yes

If you answered yes to any of the questions above, please supply additional information.

WAIVERS*

Yoga postures are held without pain. If at any time during the yoga class you feel discomfort or pain, gently come out of the pose; then rest or just breathe. It is important that you listen to your body and respect its limits on any given day.

I declare that the info I’ve provided is accurate and complete. I understand that yoga is not a substitute for medical attention, diagnosis, examination, or treatment.

I accept that neither the instructor, nor the hosting facility is liable for any injury or damages, to person or property, resulting from my taking the class.