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 Pilates Health Screening Form

 

Please complete and return this questionnaire at least 24 hours before you first session.

 

All information is kept confidentially and is used to ensure that you are safe and ready to participate in class. Please answer questions honestly and with as much detail as you can.

 

Many Thanks 

 

General Details
Health Screening

IF YOU HAVE ANSWERED YES TO ONE OR MORE QUESTIONS
Talk to your GP by phone or in person before you start becoming more physically active. Tell your GP about the questionnaire and which questions you have answered YES to.
You may be able to do any activity, or you may need to restrict your activities to those that are safe for you. Talk with your GP about the kinds of activity you wish to participate in & follow their advice.

IF YOU HAVE ANSWERED NO TO ALL OF THE QUESTIONS
You can be reasonably sure that you can start to become more physically active & take part in a suitable exercise programme. Remember to begin slowly and build up gradually.

PLEASE NOTE
If your health changes, please let me know!

Pelvic Health
Pilates Informed Consent

The pilates program will begin at a low level and will be advanced in stages depending on your fitness levels. It is important for you to realise that you are entitled to stop whenever you wish if you feel tired or are in any discomfort. 

I understand that as I will be attending as part of a group or a one to one session and that the group exercise program will not be specifically designed to my individual needs. By signing this document, I acknowledge that I voluntarily chosen to participate in a program of progressive physical exercise.  

There exists the possibility of certain dangers when exercising; abnormal blood pressure, fainting, irregular / fast or slow heart rhythm. Whilst every care will be taken to ensure your safety it is impossible to predict the body’s exact response to exer