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Home
About
Classes
One-to-One
Corporate
Online Membership
Thankful Flow Community
>
Beginner Friendly Classes
Short Classes
Meditations & Asana Alignment
60 min classes
Book a Class
Get in touch
Testimonials
Blog
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YOUR CART
Pre-Class Questionnaire
Before booking any classes or signing up to a membership, please complete the below form;
Yoga Health Questionnaire
ALL INFORMATION WILL BE TREATED CONFIDENTIALLY
Name
*
First
Last
[object Object]
Date of Birth (DD/MM/YYYY)
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Email
*
Occupation
*
What are your goals for attending Yoga / Pilates classes?
*
Do you exercise regularly?
*
Yes
No
If yes, what exercise?
*
If you have done yoga before, what is your experience and what did you enjoy about it the most?
*
Medical Background
Have you ever been told that you have arthritic joints or any bone defect?
*
Yes
No
If yes, please give details:
*
Have you had any operations or injuries in the last year?
*
Yes
No
If yes, please give details:
*
Do you suffer from backache?
*
Yes
No
If yes, please give details:
*
Do you have any other aches or pains in your body?
*
Yes
No
If yes, where, have you received medical advice and what makes it worse?
*
Are you pregnant or have you had a baby in the last 6 months?
*
Yes
No
If yes, please give details:
*
Do you have any of the following?
*
High blood pressure
Low blood pressure
Asthma
Diabetes
Anxiety
Heart problems
Circulatory problems (e.g. varicose veins)
Depression
Epilepsy/fits or faints
Respiratory problems
Chest pain
Please give details of anything else in your physical history that may affect you during class
*
Informed Consent
I understand I must inform my tutor of any changes to my health or ability to exercise and that I should refer back to a medical practitioner if I have any doubts as to safe participation. I agree to listen to my body and participate in classes entirely at my own risk.
*
Indicates required field
I agree to the use of hands on assists during practical classes
*
Yes
No
I agree to photos and videos being used for commercial purposes
*
Yes
No
I agree to my e-mail being added to the ThankfulFlow Yoga database
*
Yes
No
Submit