TESTIMONY FORM

Bikram and Rajashree will be writing more books about Bikram's unique method of hatha yoga and will be referring to some of the specific medical benefits of daily yoga practice. If you have healed a long-standing injury or other chronic physical condition through your own yoga practice, we may want to include your story in future writings, press interviews, or this website.

If you would like to participate, please answer the questions on this form. Before you begin, please understand that Bikram is mindful of the benefits of Western medical science. Bikram desires to remain in agreement with medical science. Therefore, your story of how Hatha yoga led to your improved or healed condition will never be presented as a conflict with medical science or any doctor's advice or position.

Invitation to offer your Testimony of healing
through regular practice of Bikram's Yoga

Your Name: Your Age:

Address:

Please include area code
Phone: FAX:

Email:

Describe your physical condition or illness that has been improved or cured since you began Bikram's yoga practice. (Press "enter" at the end of each line.)

The month and year your symptoms appeared.

What was the month and year you first sought medical treatment for this condition or injury?

What was your doctor(s)' treatment plan? What did your doctor think you could or could not do after medical treatment? Did the medical doctors anticipate longterm loss for you in any regard? (Press "enter" at the end of each line.)

When did you begin Bikram's yoga?

How soon did you see improvement in your condition? Describe your improvements. (Press "enter" at the end of each line.)

How long have you been practicing Bikram's yoga now?

Have you completed Bikram's Teacher Training Course? yes no
If so, when did you graduate?

Are you teaching now? yes no

Do you have or intend to open a yoga school of your own? If yes, when and where?

PLEASE CHECK ONE:
You may use my name You may describe my condition BUT DO NOT INCLUDE MY NAME.

Thank you for your help.

Bikram Choudhury, President
Yoga College of India
1862 S. LaCienega Blvd.
Los Angeles, CA 90035
.310. 854.5800
310.854.6200 FAX

Please copy (Ctrl+A) this page and paste it to your email and send to: Webmaster@BikramYoga.com