NEW CLIENT INTAKEPlease complete this form before your first class. Keeping you safe & healthy is my #1 goal. Name * First Name Last Name Email * Phone * (###) ### #### Do you have any any past/current injuries, aches or pains? * No Yes If yes, please describe: Do you have any medical conditions that I should be made aware of? (i.e.- high/low blood pressure, pregnancy, vertigo, heart conditions, arthritis, osteoporosis, etc.) * No Yes If yes, please describe: What are your goals for coming to Pilates? Check all that apply Strengthening Flexibility Mental clarity Improve posture Rehabilitation/mobility Here for a good time Weight loss Other Have you practiced Pilates before? No Yes What is your current activity level/week? 0-1 2-3 3-5 5+ Emergency Contact * First Name Last Name Emergency Contact Phone * (###) ### #### Is there anything else you think I should be made aware of? Cancellation Policy * Any cancellations received with less than 24 hours notice will be charged in full or will forfeit a credit for membership packages. We understand that life happens, but class sizes are intimate and limited so please be courteous to other 444 baddies who would have taken your spot on the reformer or mat. I AGREE I AGREE Thank you!
