Baby And Me (Postnatal) Yoga Form Get customers medical information for yoga classes First Name* Surname* Date Of Birth* DD slash MM slash YYYY Email* Have you practised yoga before?* Yes No If yes for how long?How did you hear about this course?*Select:A friendFacebookWebsiteBaby's Name* Baby's Date of Birth* MM slash DD slash YYYY Did you baby arrive:* Full-Term Premature Overdue Delivery Type:*Select:VaginalMedical InterventionC-sectionPrevious Births?* Yes No If yes, please give ages of older children* Pelvic Instability?* Yes No Pubic pain?* Yes No Back or neck pain?* Yes No High / Low Blood Pressure?* Yes No Prolonged bleeding?* Yes No Anaemia?* Yes No Constipation?* Yes No Varicose Veins?* Yes No Fluid Retention?* Yes No Sciatica?* Yes No Exhaustion?* Yes No Any other health issues not mentioned above, please specify below:Does your baby have any medical conditions? Please specify below*Any allergies?* Yes No Do you take any regular medication?* Yes No Have you had any significant medical conditions, injuries or operations (including c-sections)?* Yes No CAPTCHA