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Elizabeth Montenegro-Rye
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Yoga for Cancer Rehabilitation and Recovery Intake Form - Perfect Soul Center
One-on-one online session via Zoom
*
Indicates required field
Name
*
Age
*
Date of Yoga Therapy Session
*
Diagnosis and Details of Cancer Care/ Treatment / Medications
*
What specific concerns do you wish to address with yoga therapy?
*
Waiver of Liability :
I understand that yoga involves some physical exertion, stretching and possible emotional clearing, I agree
to take full responsibility for not exceeding my limits in the practice of yoga
. This includes seeking my health care provider's consent to attend yoga for cancer session/s.
Submitting this form means I have read and understood and agree to the terms indicated herein.
Submit
Home
About Us
Why Perfect Soul?
Elizabeth Montenegro-Rye
Teaching Opportunities and Mentorship
Donate
YOGA
Yoga Therapy
Guided Introspection
Classical Yoga
Yoga for Special Needs
Yoga for Cancer
>
Mesothelioma
Yoga Therapy for Menopause
YOGA THERAPY FOR WEIGHT MANAGEMENT
Counselling
Lifestyle Assessment
Blog
Updates
Contact Us
SUBSCRIBE