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Join our Pilates Waitlist
First things first, good on you for taking charge of your health and wellness! You should be proud of yourself and you will reap all the rewards in no time.
12
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1
What is your name?
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First Name
Last Name
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2
What is your email address?
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example@example.com
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3
What is your mobile number?
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4
How many weeks postpartum are you?
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0-6 weeks
6-12 weeks
3-6 months
6-12 months
12+ months
Other
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5
Are you currently experiencing any postpartum symptoms?
*
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Pelvic floor weakness
Diastasis recti (abdominal separation)
Lower back pain
Pelvic Pain
Postural changes
Other
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6
Have you tried Pilates before?
*
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No, never.
Yes, a couple of times.
Yes, many times.
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7
Which days of the week would suit you best for a class?
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Select as many as you like.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
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8
What time of day would be most convenient for you to attend a class?
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Select as many as you like.
Rise & Shine: 6am - 8am
After School Drop-off: 9am – 11am
Before the School Rush: 11am - 2pm
After Work: 2pm - 5pm
Sundown: 5pm - 7pm
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9
How often are you hoping to do a Pilates class?
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Once per week
Two times per week
Three times per week
I'm crazy! Give me more!
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10
Do you have any specific goals you would like to achieve through pilates?
Select as many as you like.
Strengthening core and pelvic floor muscles
Improving posture
Improving flexibility
Reducing pain or discomfort
Enhancing postpartum recovery
Preparing for childbirth
Recovering from injury
Reducing stress and promoting relaxation
Just for the fun of it!
Other
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11
How did you hear about us?
From a friend or family member
Social media
GP or healthcare provider
Google
Other
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12
Want to share something else with us? We want to know about it!
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