Which class are you interested inOnline Mum and baby Tuesday 13.30Online Mums and tots Tuesday 15.30Post-natal Workshop Chorlton 20/09/20One to oneOther
Date and place you gave birth
Are you currently breast-feeding:YesNo
Have you undergone: epidural/c-section/natural birth/water birth
List any particular conditions which may have affected your pregnancy or labour eg SPD/diabetes
Baby came late, low placenta etc
Have you done Yoga before?YesNo
Have you done Pregnancy Yoga before?YesNo
If yes, did it help you during labour?YesNo
What would you like to gain through post natal Yoga classes
Was this your first pregnancy?
If no, please give age of children
If yes, please give details
Do you currently experience any of the following. Tick any relevant symptomsTirednessSleep disturbancesSPDConstipationAnxiety / DepressionAching groinsAnaemiaDiabetesPilesLower Back PainSciaticaLow Blood PressureVaricose VeinsOedema (swollen joints)Diastasis rectiHigh Blood Pressure
Please give details of any other health issues you may encounter:
Last, have you suffered any injury or undergone any surgery (i.e. knee surgery) which could affect you Yoga practice? If so, please give details, thank you
Do you have any allergies or dietary requirements:YesNo
If yes, what kind
How did you hear about the class?
Would you like to keep in touch with Marylines news of classes, workshops, audio and video material. If yes, we'll add you to our mailing list. Your details won't be shared with anyone else.YesNo
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