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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?
FIND A TEACHER
Donate
YOGA
Yoga Therapy
Guided Introspection
Classical Yoga
Yoga for Special Needs
Yoga for Cancer
Yoga Therapy for Menopause
YOGA THERAPY FOR WEIGHT MANAGEMENT
Counselling
Blog
Updates
Contact Us
SUBSCRIBE