Full Name Mobile
Email Address
Suburb Pincode
Date Of Birth (dd/mm/yyyy) Residence Phone No.
Organization Designation
Height in ft/inches Weight in Kgs

Health Profile followup

When counselor call unanswered by student
Out of range / phone ringing
Student asked to call later
Phone busy
SMS sent
Remarks :

Remarks :

Hi......, I am .....Yoga Counselor from New Age Yoga. Can we talk now? if No, take other appointment.

no
other appointment
Remarks :

Have you filled up your health profile?

will fill up
Remarks :

Are you receiving Dinacharya SMS? Send START ADMARK2 to 09004409994
yes
no
How is it beneficial to you?
Remarks :

Have you followed the suggestions given on your health profile? You can read it in forms section in your login.

Asana : pl see videos NAY principles, testimony, regimen in sadhak regimen
Pranayama: pl video on pranayama concept in sadhak regimen
Meditation/Mind Stilling
Reflection : pl refer to the video in sadhak regimen
Nispandabhava : pl refer to video in sadhak regimen
Jalaneti : pl refer video in sadhak regimen
Jivhamulshodhanam : pl refer to weblink in sadhak regimen
Positive Diary : pl refer in home section
Walk : walk videos on YouTube Leslie Sansone
Dietary Suggestions: in forms section, also see sms about diet in sadhak regimen
Water
Tea/Coffee
Smoking
Alcohol
Any other Addiction
Sanjeevan Sadhana, rejuvenating yoga sequence, refer video in sadhak regimen
Remarks :

Do you notice any positive improvement in your health challenges?

Remarks :

Reason for discontinuing class
Remarks :
Follow Up Date (dd/mm/yyyy) Grand Total