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Water Ripple

Health form for Yoga

Before we work together, I need to know a bit more about you, your current and past health.

All of this infomation is confidential and you’ll only need to complete this when you register for the first time. If you prefer to email me your information, click here 

1. Your contact information
2. Your emergency contact (friend/family member etc.)
3. General info about you
4. Your general health
Tick any that apply:
5. Lifestyle questions
6. The legal bit

By submitting this form you acknowledge that you have shared information to the best of your knowledge. You agree to take responsibility for yourself during each session with Symi Fuchs. You agree for your details to be used by Symi Fuchs for marketing and communication purposes only. Your personal information is confidential and will never be shared with any third parties without your consent!

During yoga classes from time to time, I may record or take photos for education or marketing purposes. If for any reason you do not consent to this, please get in touch. When participating in trainings online, the content is recorded for participants to access for a limited time after the training. The training may also be sold separately, in such cases, content will be reviewed and any content deemed personal shall be removed from the recording.  

I am really looking forward to us working together soon!

Thanks for registering. See you soon!

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