New Client Forms

If you are joining us at Prana Yoga, please complete the New Client Info Sheet and the Liability Waiver prior to attending your first class.

New Client Info Sheet

First name

Last name

Phone

Address

Emergency Contact Name and Phone Number

Have you practiced yoga before?

How often do you practice yoga?

Never

Once per month

Once per week

Multiple times per week

On a scale of 1-10 (10 being the highest) how would you rate your average level of daily activity?

On a scale of 1-10 (10 being the highest) how would you rate your average level of daily stress?

What are your health goals for your yoga practice?

What aspects of yoga are you most interested in?

Physical Practice

Yoga Philosophy

Breathwork/Pranayama

Meditation

Please describe any health concerns.

I authorize the collection and use of the above personal information as is required for therapeutic treatment and related administrative purpose. I understand that all my personal information is confidential and will not be released without my signed consent. I understand that yoga is not a substitute for medical attention, examination, diagnosis or treatment. Yoga is not recommended and is not safe under certain medical conditions. By signing, I affirm that a licensed physician has verified my good health and physical condition to participate in yoga classes offered by Prana Yoga, LLC. In addition, I will make my yoga instructor aware of any medical conditions or physical limitations before class. If I am pregnant, become pregnant or I am post natal or post-surgical, my signature verifies that I have my physician's approval to participate. I also affirm that I alone am responsible to decide whether to practice yoga and participation is at my own risk. I hereby agree to irrevocably release and waive any claims that I have now or may have hereafter against Prana Yoga, LLC.

I confirm that all the information provided is accurate and agree to the above statement.