Health Questionnaire Writing Retreat Bali Information for Yoga, movement and food allergies ← BackThank you for your response. ✨ Name(required) Email(required) Doctor’s name, address and telephone(required) Do you have any severe food allergies or medically diagnosed food intolerances?(required) Yes No If yes, please provide details. Are you currently taking any medicines or receiving any medical treatment?(required) Yes No If yes, please provide details. Do you suffer from pulled ligaments or tendons?(required) Yes No If yes, please provide details. How often do you practice Yoga? Never Tried Once Sometimes Regular Practice How long have you practiced Yoga?(required) Never 6 months Less than 2 years Less than 5 years More than 5 years Have you ever been on a Yoga or writing retreat of any kind before?(required) Yes No If yes, please provide details. Is there anything else we should know? Yes No If yes, please provide details. Thank you for completing the questionnaire. Now please press submit to send. Submit Δ Share this: Share on X (Opens in new window) X Share on Facebook (Opens in new window) Facebook Like Loading...
Writing Retreat Bali 