Post Pregnancy Programme Online Form

Post Pregnancy Programme

First Visit - Online Purchase Form & Questionnaire
Name*

First NameLast Name
Contact Number*

Area CodePhone Number
Please select one from our programme*
prevnext( X )
(A) Post Pregnancy Care Programme (Comprehensive) - Online First VisitConsultation | Assessment | Winback Tecar Therapy | Prescribed Exercises & Pilates Reformer | HIEMT
$250.00SGD

(B) Post Pregnancy Care Programme (Contraindication) - Online First VisitConsultation | Assessment | Winback Tecar Therapy | Prescribed Exercises & Pilates Reformer | *This programme is specially curated for mother's who has filshie clips, tandem and ovoid implants or any other complications during/after birth.
$250.00SGD

Total

$0.00SGD
Terms & Conditions
- Our Post Pregnancy Care Programme is only available in our Marina Square Clinic

- Promotion is only available online and for one time purchase/redemption per person

- Not valid in conjunction with any other vouchers/promotions and discounts

- The promo is non-refundable and cannot be exchanged for cash in part or full and is valid for a single transaction only

- During the redemption of promo, if the value of the promo exceeds the amount stated in the promo, the difference thereof should be paid by the bearer.

- Ready Fit Physiotherapy reserves the right to vary/amend the privilege or terms & conditions without prior notice.

- Ready Fit Physiotherapy retains the right to reject any promo that has been tampered with or found in any way unacceptable.
I agreed to the terms and conditions

Payment Details

We only accept payment via paynow (bank transfer)
How to make payment:

You may save our Paynow QR Code below and upload it on your ibanking(scan & pay)

or paynow via our UEN below

UEN : 202029424Z

READY FIT PHYSIOTHERAPY PTE LTD (Ready Fit Physiotherapy @ Binjai)

Do ensure the payment page is successful, and screenshot the payment transaction for proof of payment.

Failure to do so, will be regarded as nil payment.
Upload payment screenshot*

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History of Pregnancy
Date of Delivery*

MonthDayYear
Date
Postpartum duration (for the most recent pregnancy)?*
Weeks, Months, or Years
Number of pregnancies/births*

123>3
What is/are your child(ren)'s age(s)?*
In ascending order

Type of Delivery (First childbirth)
Baby's weight at birth (in kg)
First child
Type of Delivery (Second childbirth)
Baby's weight at birth (in kg)
Second child
Type of Delivery (Third childbirth)
Baby's weight at birth (in kg)
Third child
Are you breastfeeding?*

YesNo
Pre-pregnancy weight (in kg)*
Weight gain during pregnancy (in kg) *
Any plans for more children?*

YesNoNot sure
Any complications during pregnancy and childbirth?*
If you are less than 3 months postpartum, have you obtained a clearance from your gynae to do exercises?*

YesNoNA

Activity Level
Are you doing any exercises at the moment?*

YesNo
If you answered 'yes' to the question above, please elaborate. *
How often are you exercising in a week?*

1-2 days3-4 days5-7 daysNot at all

	Often (Everyday)	Sometimes (3-4 days a week)	Rarely	Not at all
Carbohydrates (Rice, noodles, breads)
Proteins (Meat, seafood)
Vegetables
Fruits

Post Pregnancy Programme

Terms & Conditions

Payment Details

History of Pregnancy

Current Complaints: Pain

Activity Level

Dietary Habits