Ashtanga Yoga Bellingham Mysore Program Onboarding Questionnaire

downloadable version click here

1.    Name:

2.    Age:

3.    Ht. Wt.

4.    Any health concerns or physical inabilities?

5.    Emergency Contact:

6.    How long Practicing Ashtanga:

7.    Name of Ashtanga Teacher:

8.    Up to what sequence and posture have you been given by this teacher (example: Marichyasana C of Primary Series). If sequence is custom please describe in as much detail as you would like:

9.    Injuries, difficulties, postures that need assistance:

10. Do you wish to be physically (i.e. “hands on”) adjusted in Mysore class?

11. Have you taken the time to observe all conditions for the program, including signing the online waiver here; https://waiver.smartwaiver.com/w/530aec7e2ca63/web/ ?

12. Is there any reason we should hesitate in actively pursuing your Ashtanga practice?

13. Please take as long as you would like to describe anything relevant about yourself, your life, or your practice that you want your Mysore instructor to know about you: