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Date Of Birth (dd/mm/yyyy) Residence Phone No.
Organization Designation
Height in ft/inches Weight in Kgs

Feedback

As you may be aware you are asked to fill Health Profile in the beginning of class
Have you filled up Health Profile with NAY anytime ?
Have you received guidance/counselling from NAY founder Sandhya after filling your Health Profile
Have you been following the suggestions / techniques suggested by Sandhya ?
Any feedback on the suggestions related to your Health Profile ?
Remarks :

Which of these parameters important for you in Yoga class ?
Teacher\\\'s punctuality
Teacher\\\'s hygiene and dress etc
Speed of class
Teachers effort to make me do exercise
Working out and sweating in the class
Feeling of serenity and peace at end of class
Teacher\\\'s ability to increase my awareness and concentration
Studio cleanliness, ventilation, light etc
Remarks :

Have you been able to follow the Asana/Pranayam class by your teacher ? Are there any practical concerns on technique / teaching or schedule ?
Remarks :

Do you have any feedback on Teacher\'s regularity, punctuality or communication regarding same ?
Remarks :

What are the noticeable positive effects you are observing in your Wt/fitness/Energy/Stamina/Disease mgmt/Vitality etc ?
Remarks :

Do you think it is worthwhile for you to continue Yoga for better health ?
Yes will continue class
I will continue class, but later (pls mention when and why below)
I will continue Yoga at home
No. I will not continue Yoga form because (pls mention reason below)
Remarks :

How do you rate the overall Yoga experience/ Class service ?
Excellent
Very Good
Good
Average
Scope to improve (suggestions given below)
Remarks :
Follow Up Date (dd/mm/yyyy) Grand Total