Enrolment Form Copy

    Your Name (required)

    Your Address

    Your Phone Number

    Your Mobile Number

    Your Email (required)

    Have you done Pilates Before?

    Which Class are you enrolling for?

    Has your Doctor ever said that you have any sort of heart trouble or defect?

    Have you ever been told that you have arthritic joints or any bone or joint problem that may be made worse by exercise?
    YesNo

    Is your blood pressure
    HighLowNormal

    Are you pregnant or have you had a baby in the last 12 months?

    If you have children, have you had a caesarean?
    YesNo

    Have you had any operations or injuries in the last year? If so, please explain if relevant.
    YesNo

    Do you suffer from backache? If so, please explain.
    YesNo

    Have you ever been given any remedial exercises? If so, can you briefly describe them?
    YesNo

    Have you been referred by a GP, Physiotherapist or any other practitioner.

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