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Sucram Yoga Student Health Form

This health form is to gather information I feel is relevant to ensure a safe and happy practice so you get the most out of your sessions, whether that be in a class setting or a 1-2-1. Contact details are important to keep you updated regarding classes, events, retreats and Yoga related products.

All information given will be treated in the strictest confidence and stored in accordance with GDPR.

Please note, your phone number will be added to my mobile phone used for contact when necessary via SMS messaging or WhatsApp Group.

Multi-line address
Date of birth
Day
Month
Year

The following information is required to ensure your safety. Whilst Yoga or breathwork may be practiced safely by the majority of people, there are certain conditions which require special attention. If you are unsure, please consult your GP before commencing a class.

Please tick if you have any of the following medical conditions. These conditions may require modifications to your practice.
Are you taking any anti-psychotic drugs?
No
Yes
Are you/could you be pregnant?
No
Yes

Please note, pregnancy is not suitable in some sessions, please discuss with Louise to see if any class is suitable for you at this time.

Disclaimer

I confirm the above information on this Health Form is correct. I understand that it is my responsibility to:

  • Take full responsibility for my own health and wellbeing during Yoga Sessions with Sucram Yoga.

  • Check with my doctor if I have difficulties or concerns about my ability to participate in the session.

  • Advise Louise of any changes in my medical information.

  • Follow the advice given by Louise but if conflicting must be overruled by a medical expert eg. Doctor/Consultant/Physiotherapist, as Louise is not a medical expert.

  • Listen to my body, I will not work into pain.

  • Not attend a session if I am unwell.


I give consent for Louise Hebblewhite to hold my information in a safe, secure locked place and for my contact details to be stored on a password protected Laptop and mobile phone.

2025 Sucram Yoga - UK Company

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