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Email
Phone
Billing Address, City, State, ZIP Code
How is your sleep?
Hours of sleep
Smoker?
Height
Weight
How did you hear about Kaiut Yoga?
Have you practiced before? Where, and how long?
Why do you want to practice Kaiut Yoga?
What physical activities do you do? How often?
Do you have any health problems we should know about?
Have you had any recent surgeries?
Do you live with any discomfort or pain?
Please list medications
Emergency contact
Phone number
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