Name
First Name
Last Name
Email
example@example.com
What is your reasoning for wanting 1-2-1 Training?
PXBT & Dance Technique
Pilates X Strength
Mobility & FRC
Improve mobility / flexibility
Injury prevention / rehabilitation
General fitness & well-being
Have you trained in a any of the following?
Dance - Please specify style & experience)
Pilates
Strength / Resistance Training
Gym Training
Mobility / S&C
What style of dance / experience & level
if applicable
How often do you currently train/exercise per week?
0-1 hours
2-3 hours
3-4 hours
4-5 hours
6+
Do you have any current injuries, pain, or medical conditions that may affect your training or have you had past injuries or surgeries I should know about?
What do you hope to achieve with the PXBT method?
Improve upper body strength
Improve lower body strength
Improve balance and coordination
Increase core strength
Increase muscle mass & tone
Improve flexibility & mobility
Improve power & dynamics
Improve overall sports performance
Additional Information: Is there anything else you would like me to know to tailor your training?
DANCE OPTION : Tick the boxes which apply:
Rows
I really struggle
Somewhat struggle
Satisfied
Turnout & rotation
Port de bras & placement
Adage & extensions
Core & posture
Allegro
Balance & centre practice
Pirouettes
Pointe work
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