Questionnaire | Mary Miall Yoga | Berkshire

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MARY MIALL YOGA

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Questionnaire

Have you done any yoga before? *

No, I've never tried it

Maybe once or twice

I can't remember

Yes, occasionally

Yes, regularly

Yes, I practice daily

What is your primary reason for coming to yoga? *

Arthritis

Back Pain

Stress

Some peace and quiet

Improve for sport, flexibility, mobility

Other, please state below

Do you have any specific areas of weakness in your body? *

Lower limbs: Feet, Knees

Lower limbs: Legs in general

Hips

Upper limbs: Hands, Wrists

Upper limbs: Arms in general

Back

Neck and Shoulders

Do you have any injuries, medical conditions or other considerations? *

None

Stress

Sports or other injury

Medical Condition

Other, add to comments

Please note, any new injuries should be seen by a medical professional first.

Thanks for submitting!

I will be in touch.

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