• Intake form

    self-care/pilates
  • Pick a Date   
          
                               
             

    How did you hear about us?

    Who referred you?

    Do you have any injuries, aches, or pains (old or new)? Please describe them.

    Are there any other health concerns that need to be considered (ie. asthma, diabetes, high blood pressure, medications)?

    Are you presently doing other forms of therapy (massage, chiropractic, physical therapy, osteopathy)?

    Are you or were you physically active in sports, exercise programs, or other physical activity? Please describe:

    Have you had any past training in pilates, yoga or TRX training? If yes, when and where? 

    What is your occupation?  

    What are your goals? What do you want most from this program?   

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