Health Questionnaire

    Yoga Health Questionnaire

    All information is strictly confidential. Please answer all questions.

    Your contact details

    About you


    Your health

    Certain health conditions require special attention when practising yoga. Please indicate if you have any of the following medical conditions and then provide further information. If you are unsure, please consult your GP before starting classes.


    The following conditions may affect your practice and it will be useful for your yoga teacher to be aware of them.




    Please read carefully; your submission of this form will be taken to indicate your understanding and acceptance of the following:

  • By submitting the questionnaire, you are confirming that the contents are true and accurate to the best of your knowledge. Please notify your yoga teacher of any changes to your responses in this questionnaire as soon as possible.
  • If you are in any doubt as to whether you are medically fit to participate in a yoga class, you must obtain professional or specialist advice from your doctor before participating.
  • In all classes, whether face-to-face or live-streamed, always follow your teacher's safety instructions and listen to your body. Where a movement is beyond your ability, feels too difficult or causes you any discomfort or pain, please do not continue that movement.


    ageless-yoga would like to use your contact details to keep you informed of training, events and relevant updates. To ensure that we only communicate with you in the manner you prefer, please indicate below your agreement or otherwise to the following means of communication: