Ebru Evrim Yoga Pilates | Health Questionnaire

First Name *

Last Name *

E-Mail *

Phone Number *

Emergency Contact

Age Group

Have you done Yoga/Pilates before? *

Which aspects of Yoga most interest you?

Please tick as many as you wish:

Physical postures (asanas) Relaxation Chanting & Healing Breathwork (pranayama) Meditation Other (please specify):

Which aspects of Pilates most interest you?

Please tick as many as you wish:

Core strength Increasing range of motion Movement Flexibility Being subtle Other (please specify):

If you answered yes to any of the conditions above, please give details

Do you have any other conditions, which affect your mobility or are likely to cause you concern when doing Yoga/Pilates?

If Yes, give details:

How did you first hear about this class?

Confirm your responsibility *

I take full responsibility for my health during the yoga/pilates classes. I will inform my yoga/pilates teacher of any medical changes.

Confirm information is correct *

I confirm that all information provided above is correct and up to date to the best of my knowledge

Subscribe to newsletter

Your information will not be shared with any 3rd party entities.

I agree to receive offers and newsletters from Ebru Evrim Yoga/Pilates

Health Questionnaire