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Please complete this screening form prior to a class or session with Harris Mind & Body.
Please view it as your responsibility to make sure your HMB teacher is fully aware of your current health conditions, so please review this information regularly.
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This information is strictly confidential and only used to help us - better help you.
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Please note boxes with a * must be completed.
The form will not submit if a * box has been left empty.
Thank You
HMB Team
We need to ask you some additional information to help us best look after you after your pregnancy. You will notice - much of the form is the same but there is now some extra sections to complete. If you have any questions or concerns please don't hesitate to ask us.
