SPECIAL ANNOUNCEMENT!
I offer private Thai Yoga sessions around the country Please click here for more information.
Welcome to the Center for Thai Yoga Body Therapy's online appointment scheduler. In order to make an appointment, we require that you fill out & submit this client information and release form. Once you submit your request, the Center will contact you for confirmation within 48 hours.
 

Please contact me if you would like to offer private Thai Yoga sessions for your staff &/or clients in your studio or offices. I regularly travel to Chicago, New York, Orange County and Los Angeles as well for sponsored workshops & private sessions, and would be happy to work out a schedule for you, your company, or your studio.

Please click here to read about how to prepare for your session. It is important that you follow these instructions; we recommend that you print them and re-read them the day before your appointment.

This Page is down until further notice. Please contact us by calling or emailing: 

Phone: 619 468-9283

Email: Tarnofsky@earthlink.net

Thank you for choosing the Center for Thai/Yoga Body Therapy.

Client Information
Name
  Address and email
Profession
Phone
Requested Date & Time
Date of Birth
Referred By

General & Medical Information

Do you receive or do any form of alternative  therapy?
ie: massage, yoga, chiropractic, dance,et
Yes No
Explain:
Do you frequently suffer from stress? If Yes, where
Yes No
Do you experience frequent headaches? If yes, how often
Yes No
IAre you pregnant?
Yes No
Are you Diabetic?
Yes No
Do you have high blood pressure or very low blood pressure. 
Yes No
Are you epileptic?
Yes No
Are you taking any forms of medications, herbs, vitamins
Yes No
What type(s)?
Have you had any surgery? 
Yes No
Explain:
Have you had any broken bones? Where and when if yes. 

 
Yes No
Do you have any tension or soreness in a specific area?
Yes No
Explain:
Are you very sensitive to touch/pressure in any area?
Yes No
Explain:
Do you have any numbness, or stabbing pains anywhere?
Yes No
Explain:
Do you have any other medical/physical condition I should be aware of?
Yes No
Explain:
By initialing in this box, I agree to the following terms & conditions:

I understand that the healing work I receive is provided for the basic purpose of relaxation, stress reduction, and relief of muscular tension. If I experience any pain or discomfort during this session, I will immediately inform the practitioner so that the pressure and/or strokes may be adjusted to my level of comfort. I further understand that THAI/YOGA BODY THERAPY should not be construed as a substitute for medical examination, diagnosis, or treatment; and that I should see a physician, chiropractor, or other qualified medical specialist for any mental or physical ailment that I am aware of. I understand that Yosel Tarnofsky is not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat any physical or mental illness, and that nothing said in the course of the session(s) given should be construed as such. Because THAI YOGA is contraindicate (should not be done) under certain medical conditions, I affirm that I have stated all my known medical conditions, and answered all questions honestly. I agree to keep the practitioner updated as to any changes in my medical profile, and understand that there shall be no liability on the practitioner 's part should I fail to do so.

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Copyright 2000, 2001The Center for Thai/Yoga Body Therapy
Created by AT GROUP

Yosel Tarnofsky, Director of the Center for Thai/Yoga Body Therapy is a member of, or affiliated with, the following organizations:

ITTA, Inc.
Institute of Thai Massage
American Massage Therapy Association
Madre Grande Monastery
AsianBodyWork.Com
Yoga Works
Full Spectrum Yoga