Registration Form Full Name*How much physical activity do you have ?Exercise, working etcHousehold choresMiscellaneousHow many hours do you sleep ?*How is your sleep ?Deep & SoundWith DreamsDisturbedLack of sleepDietWhat is your mental status usuallyVery happyPleasant/contentedAverageSad/fearfulvery anxiousEnergy LevelFamily enivonmentVery happy & supportiveHappy & helpfulAverageNeeds imporvermentVery unhappy & hostileIf you have any other problem for next question choose appropiate box to fill it :ConstipationNeverRarelySometimesFrequentlyAlwaysAcidityNeverRarelySometimesFrequentlyAlwaysIndigestionNeverRarelySometimesFrequentlyAlwaysHeart BurnNeverRarelySometimesFrequentlyAlwaysLower back ache/stiffnessNeverRarelySometimesFrequentlyAlwaysCervical/ other neck problemsNeverRarelySometimesFrequentlyAlwaysBody AcheNeverRarelySometimesFrequentlyAlwaysHeadacheNeverRarelySometimesFrequentlyAlwaysTirednessNeverRarelySometimesFrequentlyAlwaysBreathing ProblemNeverRarelySometimesFrequentlyAlwaysAny eye ProblemNeverRarelySometimesFrequentlyAlwaysWhich Class Section would you like to join ?Weekday Morning SessionWeekday Afternoon SessionWeekday Evening SessionWeekend ClassesSendThis field should be left blank
