HEALTH ON BOARDING FORM Name * First Name Last Name Email * Phone Number Tell me where you are in your journey? * Please select any and all that you are interested in: Pilates - In Person Pilates - Virtual Private Session Duet Sessions Apparatus Classes Mat Classes Movement Training Pelvic Floor Health Injury Rehabilitation Pre-natal Post-Natal Aging Gracefully Home Workout Workshops Please select all medical conditions that apply: Heart Condition High Blood Pressure Neurological Condition High Eye Pressure Respiratory Condition Osteopenia Osteoporosis Neuropathy Diabetes Please list any pertinent medical conditions, surgeries and treatments with dates and diagnosis. Please list former or current physical activity or exercise. Please list your goals. Thank you!
