Yoga classes with Liz Before coming to yoga classes, please could you complete the form below so I know a little bit about you and can adapt the class according to your needs. Thank you Question Title * 1. Contact information ( I will only contact you to notify you if classes are changed for any reason) Name Email Address Phone Number Question Title * 2. Age group under 25 25-45 46 - 60 over 60 Question Title * 3. During the day for your occupation are you ... Mostly sedentary (eg desk/office job) Mostly physically active Other (please give an indication of the level of physical activity involved in your occupation) Question Title * 4. What are your reasons for coming to yoga classes? Question Title * 5. Previous yoga experience Question Title * 6. Do you experience any of the following ? (this information is to keep you safe practicing yoga and will be kept strictly confidential) Current injuries or recurring injury Back pain Neck or shoulder pain Joint pain (eg kness, ankles, wrists) Frequent headaches High blood pressure Low blood pressure Heart disease or issues Diabetes Arthritis or osteoporosis Asthma or allergies Stress related issues Low mood Epilepsy / seizures Chronic fatigue or chronic pain None of the above Please expand, or add anything else you think I should know about. Please include any medication you might be taking. Question Title * 7. If you are a woman, are you Pregnant Experiencing negative effects from menopause or perimenopause None of the above Please elaborate Thank you. This information will be kept private and you have the right to have it deleted from record at any time. Done