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Yoga Therapy Intake & Liability Form

Birthday
Month
Day
Year
Multi-line address

Please provide an emergency contact (name, relationship and cell number)

What brings you to yoga therapy? You can share whatever feels relevant—physical concerns, stress, overwhelm, injury recovery, or general curiosity. There is no need to be formal or detailed.

Is there anything else you feel I should know before we begin working together?

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By signing, I confirm that I have read and understood the information above, and I voluntarily agree to participate in yoga therapy sessions.

DISCLAIMER: THIS WEBSITE DOES NOT PROVIDE MEDICAL ADVICE. The information, including but not limited to text, graphics, images, and other material contained on this website, is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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