Body To Baby Mother & Baby Yoga Health Questionnaire.

Please complete the form to the best of your knowledge and be assured that it will be treated in the strictest confidence. The questionnaire is just designed to make sure that you and baby can practice safely. If there is anything you are unsure about or would like to chat through, please

Before you fill out this questionnaire and send the form back to Body to Baby, we advise you read the Privacy Policy so you understand and accept what happens to your data. By you forwarding the questionnaire on to Us We will assume that you accept the Privacy Policy as stated. 

Before you fill out this questionnaire and send the form back to Body to Baby, we advise you read the Privacy Policy so you understand and accept what happens to your data. By you forwarding the questionnaire on to Us We will assume that you accept the Privacy Policy as stated. 

 

Name *
Name
Preferred Contact *
Please indicate your preferred method of contact in case of cancellation
Was labour......
Nature of delivery ....
Delivery environment....
Drugs administered during labour....
Any stitches required?
Was your baby....
Since birth have you experienced any of the following?
Since birth has your baby experienced any of the following?
Client Declaration *
CLIENT DECLARATION: As far as I am aware, I have disclosed to my yoga teacher all information regarding my health relevant to the practise of yoga in the mother & baby yoga classes. I take full responsibility for all applications of yoga I practise in the class and outside the class. I fully understand that the recommendations, ideas or techniques expressed and described in the mother & baby yoga classes cannot be regarded as a substitute for the advice of a qualified medical practitioner. Any uses to which the recommendations, ideas and techniques are put are at my sole discretion and risk.