Health and Fitness Questionnaire

H&F

1-Have you practice Iyengar yoga before? If yes, how long for?(required)

2-Do you practice any other form of exercise/sport? If yes, what?(required)

3-Are you under medication at all? If yes, what for?(required)

4-Have you any blood-related condition? (e.g. high or low blood pressure, high or low sugar levels, etc)(required)

5-Have you any heart condition?(required)

6-Have you any eye or ear conditions (e.g. detached retina, glaucoma, dizziness, tinnitus)?(required)

7-Can you sit on the floor and get up unaided?(required)

8-Have you ever had any joint problems, broken bones, operations, or history of hernia? (required)

9-Are you pregnant or breast-feeding?(required)

10-Have you any history of petit and grand mal (epilepsy)?(required)

Please note Covid precautions still applies.If you have contracted Covid, DO NOT come to the studio, but let us know and do the class from home via zoom.If you have been pinged, or have been in contact with someone with covid, do a lateral flow test and only come to the studio if it shows negative. Thank you for your understanding. -This questionnaire is not comprehensive; please let us know of any other condition you might be suffering from as it may influence your practice, even asthma, bad knee, back, or other joint problems, recovering from Covid-19, we need to know.

Name(required)

Phone(required)

Email(required)

Website

Emergency contact number, name and relation.

Which class/es you would like to join?(required)

Iyengar certification mark Only Certified Iyengar Yoga teachers are permitted to use
“Iyengar Yoga” certification mark! It is a sign of excellence,
clarity and depth of understanding of the art, science and philosophy of yoga.

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