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New Client Forms

New Client History Form

The first step in fitness, recovery, and well being is for us to know all about your concerns, pain, symptoms and goals. Please assist your Pilates instructor by answering the following questions as completely and accurately as possible. The information gathered will allow us to provide you with a safe and effective fitness program. We also require knowledge of your past medical history which is kept completely confidential.

Thank you for your cooperation. If you have any questions or concerns with any part of this form, you may leave it blank and ask your Pilates instructor.


Contact/Identifying Information







Interests/Goals














Injuries and Pain


















Past Medical History. Please reply yes or no to all of the following conditions (information will remain confidential):




















Hormonal Health







Survey



 

8 + 5 =  

Thursday, November 26th, 2020 at 11:59pm
Thursday, November 26th, 2020 at 11:59pm
Thursday, November 26th, 2020 at 11:59pm
Thursday, November 26th, 2020 at 11:59pm
Thursday, November 26th, 2020 at 11:59pm
Thursday, November 26th, 2020 at 11:59pm
Thursday, November 26th, 2020 at 11:59pm
Thursday, November 26th, 2020 at 11:59pm
Thursday, November 26th, 2020 at 11:59pm
Thursday, November 26th, 2020 at 11:59pm
Thursday, November 26th, 2020 at 11:59pm
Thursday, November 26th, 2020 at 11:59pm
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