info@pats-pilates.co.uk

"Pull up, pull in & breathe"

Consultation

Thank you for booking your initial Pilates Consultation at PATS PILATES.

Our team look forward to meeting you and guiding you along the Pilates path.

Health Form & Payment

To secure your booking please complete the questionnaire below and make payment.

01. Personal Details

02. Health Questionnaire

Do you, or have you suffered from:

Heart disease inc. chest pain and angina

Surgery in the last 12 months

Increased blood cholesterol levels

Muscle injury or joint pains

Hypertension

Back pain or injury

HypNotension

Hernia

Lung disorders; asthma, bronchitis or shortness of breath on exertion

Any chronic illness inc. arthritis, osteoporosis

Any illness relating to blood circulation, varicose veins

Are you pregnant (EDD)

Have you ever had a stroke

Have you had any recent illnesses

Are you currently on medication

Have you had a medical check-up in the last 12 months

If you've answered Yes to any of the above please provide details:

Lifestyle and eating habits*:

Reason for joining PATS Pilates*:

Anything else you may think relevant:

How did you hear of us*:

03. Payment Details

Total: £50.00

The data on this form will be treated with the strictest of confidence and will only be used by PATS PILATES for health and fitness related purposes. All data will be disposed after 3 months of your last class. Are you happy for us to store your contact details on a computer for administrative purposes?

Please Note: Instructors at PATS PILATES use hands on correction during exercise prescription to ensure correct muscle activation and alignment is maintained.

By signing this form I confirm that within the last 14 days, I have not had any symptoms associated with COVID-19 (coughs, fever, breathing difficulties) and I have not come into contact with anyone known to have the COVID-19. Should this change and I experience symptoms anytime in the future, I shall notify PATS PILATES.

Consultations and Personal Training payment must be paid in advance, where less than 48 hours notice is given the fee is non-refundable nor transferable. To cancel your place on a class register a full month's notice/payment is required.

Can we stay in touch

Please check if you're happy for us to stay in touch with information and advice

Join PATS PILATES today

Take a look at our class timetable and request a place, or view our Pilates Instructor courses and workshops.