Name * First Name Last Name Address * City/Town State/Province Post Code Country * Phone Email Address * Date of Birth Occupation Education First Spoken Language Other Languages Marital Status Do you have Children? Emergency Contact Name Phone Relationship to you Medical Information Medication Are you currently taking any medication? If yes, for what condition? History Do you have any history of psychological or emotional issues? If yes, please describe? Health Care Are you currently in the care of a medical or natural health care practitioner? If yes, please describe. Injuries Do you have previous injuries that may affect your practice? If yes, please describe. History of Mental Health Do you have any history of depression or mental health challenges? Yoga Experience Styles What yoga styles do you practice and which have you explored? Experience How long have you been practicing? Spiritual Practices Do you have any other spiritual practices and how long have you been practicing them? Inspiration Please share a few inspiring details about your practice: Why Yoga? What attracts you to spirituality and specifically the path of yoga? Meditation Do you have a meditation practice? Do you have any other spiritual practices? Teaching Are you currently teaching yoga or meditation? If yes, share some details about your classes: Why Please express why you want to become a yoga teacher and why you are choosing to participate in this course. How did you find us? Google Search Facebook Friend Somewhere Else Thank you!
