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Client Intake Form
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Name
*
First
Last
Age
Contact no.
*
Have you done Yoga before?
Yes
No
Third Choice
If yes, for how long?
Why do you want to practice yoga?
*
Do you have any Health issues?(specify and give details) Also, if you are under any medication please mention it. *
*
Your time preferences?
6am-7am
7am-8am
Other
If others, please mention you time preference.
Please select your class pass.
*
Drop in (Rs 500 per class)
Weekly (Rs 250 per class)
Monthly (Rs 150 per class)
Thank you for your time! If you have any special request, please feel free to share.
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