Client Questionnaire

Does your occupation involve repetitive movements/ prolonged sitting/ postures/ heavy lifting/ bending?

Are you involved in any active sports/ hobbies?

Do you have any previous or current injury that has impacted your general fitness/ lifestyle?

Have you ever practised pilates before?

Have you been referred to pilates by a health professional?

What aspect of your physical wellness would you like to focus on ?

Are you experiencing any of the following problems/ conditions?

Are you pregnant? If so how many weeks?

Have you had a baby in the last year?

Neck problems? (If yes, please tick the following)

I take full responsibility for my health during pilates and I will inform the instructor of any medical changes that may affect my ability to participate.*

I have read the terms and conditions, understood and completed the form to the best of my knowledge.*

I hereby sign that all my personal details are accurate.*

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