CLIENT INFORMATION & REGISTRATION FORM


EMERGENCY CONTACT

IMPORTANT – PLEASE READ
The following information is required to ensure your health & wellbeing. Whilst yoga, meditation & holistic therapies may be practised safely by most people, there are certain conditions that require special attention. If you are unsure, please consult your GP before commencing class/therapy. Please indicate in the boxes below whether or not you have any of the following medical conditions & then provide further information.


DISCLAIMER – PLEASE READ
Please take care when filling in the above questionnaire & check the contents are accurate before you submit it. By submitting the questionnaire, you are confirming that the contents are true & accurate to the best of your knowledge. Please notify your practitioner of any changes to your responses in this health questionnaire before participating in classes, treatments or therapies subsequent to those changes. Neither your practitioner, nor B.blissd, are qualified to express an opinion that you are fit to safely participate in any B.blissd offerings. You must obtain professional or specialist advice from your doctor before participating if you are in any doubt.

B.blissd practitioners are appropriately qualified & accredited, with high standards of teaching, therapy & best practice within their scope of practice. Where possible, your practitioner may offer suitable modifications or adjustments & practices to suit different levels of experience & ability. Please always let the practitioner know before the session if this is your first time taking part in yoga, meditation or holistic therapies, or if you are not confident about your experience &/or ability.

Online/Recorded (Remote) Classes/Workshops/Therapies: Please note that in online sessions the practitioner may not be able to see you at all times. Where you have declared a health condition, please contact the practitioner before the session if you would like to request that you are provided with suitable modifications or adjustments wherever possible. Where you are using pre-recorded material, you will not be able to request specific adjustments or modifications.

All Offerings: Whether face to face, online or pre-recorded, always follow your practitioner’s safety instructions & listen to your body. If a movement or class/therapy is beyond your experience or ability, feels too difficult for you, or you experience any discomfort, please do not continue the movement, class or therapy.



DECLARATION
I, the undersigned, understand that yoga/meditation/holistic therapies is not a substitute for medical attention, diagnosis or treatment. If I have previous/current physical issues/injuries, I confirm that I have the approval of my doctor to take part in yoga/meditation/holistic therapies, & I recognise that it is my responsibility to notify the practitioner of any illness or injury before every session. I accept that neither the practitioner, nor B.blissd, is liable for any injury, or damages, to person or property, resulting from taking part.


B.BLISSD PRIVACY STATEMENT
In order to comply with relevant Privacy Regulations, it is necessary for us to check whether or not you are happy for B.blissd to retain your contact details & to send you information that we believe may be useful to you, including wellbeing and self-care tips, upcoming events and relevant updates. We only hold information when it is necessary to do so, in order for us to carry out our work (and when you have given us permission to do so). To ensure that we only communicate with you in the manner of your preferred choice, please tick the box below, to give your consent for me to the following means of communication to contact you: