Postnatal student info & disclaimer

Once you’ve contacted me to book a class, please fill out this form.

The details you share here help to ensure that you receive appropriate care, advice and practices during your Grounded Yoga classes, and ensure that you’re updated on changes and additions to the class schedule.

Your information is private and confidential, and won’t be shared without your consent.

Bookings and cancellations.

Once you submit the below form, you’ll receive a text message on the Friday before our next class to confirm your booking.

We really appreciate a message if you need to cancel or if you’re running late so we know how many mats to lay out, how many kids to expect and to leave the door open for you if you happen to run a bit late.

Name

First Name

Last Name

Phone

(###)

###

####

Suburb

Occupation

Medical history, CONFIDENTIAL. Aside from birth, have you required any significant healthcare in the past 5 years? If yes, what and when.

Do you experience any of the following conditions (check all that apply)

High or Low Blood Pressure

Heart Conditions

Asthma

Arthritis

Carpal Tunnel

Neck Issues

Back/Spinal Issues

Please advise of any other ongoing health issues here.

If you have practiced yoga, which styles, schools or lineages?

Tell us a little about your birth - vaginal/c-section, straightforward/complex, how you felt about your birth at the time and how you feel now, and any other relevant info.

Baby's name and age.

Do you have any physical concerns regarding your pregnancy, birth or post-natal recovery, eg achy pelvis, prolapse of any kind, still tender from c-section? Have you seen a doctor/physio or other postpartum healthcare provider?

You are welcome to share any information about your headspace or psychological health that may be relevant to your yoga practice. This is encouraged, but optional.

What do you hope to feel or find in your postnatal yoga class?

Date submitted

YYYY

I confirm by submitting this form that I understand the instructions given during class are intended as guidance and it is therefore my responsibility to adjust my practice according to my ability, to ensure no injury occurs, and inform the teacher prior to class of any changes in my physical condition.

I agree

I declare that I release Grounded Yoga of any responsibility for any injury sustained and that I will take full responsibility for the physical, psychological and emotional well being of myself and any children in my care during yoga classes.

I agree